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How, exactly, does prevention save money?

Alex with Nurse Practitioner Amy

 

Alex is a 13-year-old living in Chicago. He likes playing soccer with his cousins, and running. Alex also has asthma, a disease which, among other things, prevented him from being as active as he wanted to be by constricting his airways to the point where he was gasping for breath. For the past year Alex has been a patient aboard Mobile C.A.R.E. Foundation’s Asthma Van, a mobile health clinic that diagnoses, educates, and treats low-income children with asthma at no cost.

In low-income Chicago areas, over 25% of children suffer from asthma . Because specialty care and medication is not easily accessible and often  expensive (one common asthma medication, for instance, costs $280 per month), and parents working low-wage jobs have inflexible schedules, many neighborhoods that carry the highest rates of asthma are also the hardest to reach. As a result, Illinois has one of the highest asthma mortality rates in the country—more than neighboring Wisconsin and Missouri combined—and  spends $280 million annually in hospitalization costs associated with untreated asthma. Against such overwhelming numbers, what impact could an Asthma Van have by bringing care to distressed neighborhoods and providing education on what asthma is and how to treat it? Actually, it turns out programs like this can make all the difference.

For example, the cost to the Chicago healthcare system per asthmatic child hospitalized is $15,155 a year according to the Illinois Department of Public Health. By contrast, 97% of children enrolled in Mobile C.A.R.E. will not have to visit an ER or hospital. It costs an Asthma Van an average of $900 per child annually to provide care. Just from our 1,000 patients, the local healthcare system saved about $5 million in direct cost (children we know had been hospitalized immediately before enrollment) and $14 million in potential cost last year alone. That’s a 12-to-1 return on investment, before we even talk about the improvement in the child’s quality of life or the substantial decreases in both school absenteeism and patient inactivity. To put it in perspective, for the same amount of money spent just on emergency care for asthma, Asthma Vans could provide comprehensive treatment to all 121,610 Chicago children with asthma and then some.

And how is Alex, whose asthma was so bad before enrollment that he occasionally couldn’t breathe enough at night to go to sleep? Since enrolling in the Asthma Van, he has virtually no asthma symptoms. “I feel better when I take my medicine,” Alex said, “but if I don’t take my medicine, I feel tired all the time, and I can’t breathe very well.” Amy, our nurse practitioner, reports that he’s lost weight as a result of being more active, and his grandmother tells us his grades are better because he’s not sleepy at school. This August, Alex was able to take part in a soccer tournament with his cousins. Alex is just one picture of life with asthma under control. Bringing quality care into distressed neighborhoods, it turns out, saves money and changes lives.

This post was initially published on the SoundAsthma blog

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