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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Edwards, Rhiannon T. Neal, Richard D. Linck, Pat Bruce, Nigel Mullock, Linda Nelhans, Nick Pasterfield, Diana Russell, Daphne Russell, Ian Woodfine, Louise |
| Spatial Coverage | Wales |
| Description | Country affiliation: United kingdom Author Affiliation: Edwards RT ( Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK. r.t.edwards@bangor.ac.uk) |
| Abstract | BACKGROUND: There has been little rigorous economic analysis of the relationship between asthma and improved housing. AIM: To evaluate the cost-effectiveness of installing ventilation systems, and central heating if necessary, in homes of children with 'moderate' or 'severe' asthma. DESIGN AND SETTING: 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. METHOD: 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. RESULTS: 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 PedsQL™ 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. CONCLUSION: 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. |
| File Format | HTM / HTML |
| ISSN | 09601643 |
| e-ISSN | 14785242 |
| DOI | 10.3399/bjgp11X606645 |
| Journal | British Journal of General Practice |
| Issue Number | 592 |
| Volume Number | 61 |
| Language | English |
| Publisher | Royal College of General Practitioners |
| Publisher Date | 2011-11-01 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | Open |
| Subject Keyword | Research Support, Non-u.s. Gov't Health Services Prognosis Discipline Family Medicine Wales Child, Preschool Cost-benefit Analysis Patient Acceptance Of Health Care Quality Of Life Prescription Drugs Questionnaires Prevention & Control Randomized Controlled Trial Therapeutic Use Asthma Utilization Heating Adolescent Ventilation Anti-asthmatic Agents Statistics & Numerical Data |
| Content Type | Text |
| Resource Type | Article |
| Subject | Family Practice |
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