Back to Search Start Over

Enhancing ventilation in homes of children with asthma: cost-effectiveness study alongside randomised controlled trial.

Authors :
Edwards RT
Neal RD
Linck P
Bruce N
Mullock L
Nelhans N
Pasterfield D
Russell D
Russell I
Woodfine L
Edwards, Rhiannon T
Neal, Richard D
Linck, Pat
Bruce, Nigel
Mullock, Linda
Nelhans, Nick
Pasterfield, Diana
Russell, Daphne
Russell, Ian
Woodfine, Louise
Source :
British Journal of General Practice; Nov2011, Vol. 61 Issue 592, p733-741, 9p
Publication Year :
2011

Abstract

<bold>Background: </bold>There has been little rigorous economic analysis of the relationship between asthma and improved housing.<bold>Aim: </bold>To evaluate the cost-effectiveness of installing ventilation systems, and central heating if necessary, in homes of children with 'moderate' or 'severe' asthma.<bold>Design and Setting: </bold>An incremental cost-effectiveness analysis alongside a pragmatic randomised controlled trial of a tailored package of housing modifications designed to improve ventilation and household heating in homes within Wrexham County Borough, Wales, UK.<bold>Method: </bold>A total of 177 children aged between 5 and 14 years, identified from general practice registers, were studied. Parents reported on the quality of life of their children over a 12-month period. General practices reported on health-service resources used by those children, and their asthma-related prescriptions, over the same period.<bold>Results: </bold>The tailored package shifted 17% of children in the intervention group from 'severe' to 'moderate' asthma, compared with a 3% shift in the control group. The mean cost of these modifications was £1718 per child treated or £12300 per child shifted from 'severe' to 'moderate'. Healthcare costs over 12 months following randomisation did not differ significantly between intervention and control groups. Bootstrapping gave an incremental cost-effectiveness ratio (ICER) of £234 per point improvement on the 100-point PedsQLâ„¢ asthma-specific scale, with 95% confidence interval (CI) = £140 to £590. The ICER fell to £165 (95% CI = £84 to £424) for children with 'severe' asthma.<bold>Conclusion: </bold>This novel and pragmatic trial, with integrated economic evaluation, reported that tailored improvement of the housing of children with moderate to severe asthma is likely to be a cost-effective use of public resources. This is a rare example of evidence for collaboration between local government and the NHS. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
09601643
Volume :
61
Issue :
592
Database :
Complementary Index
Journal :
British Journal of General Practice
Publication Type :
Academic Journal
Accession number :
104595045
Full Text :
https://doi.org/10.3399/bjgp11X606645