PT  - JOURNAL ARTICLE
AU  - Karen Kam
AU  - Alberto Nettel-Aguirre
AU  - Ian Mitchell
AU  - David Johnson
AU  - Gillian Currie
TI  - Cost impact of a multidisciplinary clinic for children with problematic severe asthma
AID  - 10.1183/13993003.congress-2016.PA1531
DP  - 2016 Sep 01
TA  - European Respiratory Journal
PG  - PA1531
VI  - 48
IP  - suppl 60
4099  - http://erj.ersjournals.com/content/48/suppl_60/PA1531.short
4100  - http://erj.ersjournals.com/content/48/suppl_60/PA1531.full
SO  - Eur Respir J2016 Sep 01; 48
AB  - Introduction: The Intensive Management of Asthma Clinic (IMAC) is a novel multidisciplinary clinic for children with problematic severe asthma. The cost of maintaining such a clinic compared to a standard asthma clinic has not been studied.Objective: The purpose of the study was to examine the cost impact of consolidating resources in the IMAC. We hypothesized that there would be an overall cost saving in healthcare utilization, compared to patients managed in a standard asthma clinic.Methods: This quasi-experimental retrospective study compared all patients enrolled in the IMAC between 2008-2011 and patients (<18 yrs) with problematic severe asthma in the standard asthma clinic at Alberta Children's Hospital, Calgary, Canada. Data on healthcare utilization (clinic visit, ED, hospitalization) was collected previously, and combined with costing data, including patient-borne costs. This was grouped and analyzed in 3-month intervals 2 years prior and after time 0 (1st IMAC visit, or met criteria for severe asthma). Primary analyses used linear mixed effects modeling.Results: IMACStandardClinic328(246 to 411)4(-74 to 82)ED-70(-90 to -51)-33(-47 to -20)Hospitalization-135(-197 to -73)-135(-197 to -73)Patient-borne-54(-91 to -16)-54(-91 to -16)Difference in costs over time, $(CAD), 95% CIAcross patients and the time intervals, there was a mean net savings in the standard clinic of $218, and a mean net spending in the IMAC of $69.Conclusion: The IMAC reduced unplanned ED visits and hence costs, but may be more expensive than standard asthma intervention. Decision-makers must judge whether benefits associated with multidisciplinary clinics are worth the potential additional resources required.