MSU research: School-based asthma therapy improves student health, lowers medical costs

EAST LANSING, Mich. – Nearly 5 million children in the U.S. have asthma, a disease that narrows the airways. While there’s no cure, it can be controlled with anti-inflammatory medications. However, it can be tough for kids to take their daily medication on schedule, especially while they’re in school.

School-based asthma therapy, or SBAT, is a way to help students breathe easier. SBAT is a program that relies on teamwork between schools, school nurses, health care providers, insurance companies, pharmacies and families.

Students say that they like learning to be responsible for taking their medication, they can run around outside, and they feel better when they take their medicine regularly.

“We help families get better adherence to kids’ asthma control medication regimens by having the school nurses give them their meds on the days that they go to school,” said Kimberly Arcoleo, professor at the Michigan State University College of Nursing and primary investigator on the new research.

“Students get two inhalers with controller medication,” she added. “One that goes to school and one that stays home so it doesn’t have to move back and forth. The school nurse administers the medication to the kids each school day according to their health care provider’s instructions. Some kids need it once a day, some need it twice a day.”

Arcoleo and her co-researchers’ findings were recently published a paper in the Journal of Allergy and Clinical Immunology: Global and detail SBAT results for children ages 5 to 19 years old in Columbus, Ohio. The research was funded by a grant from the National Heart, Lung and Blood Institute, part of the National Institutes of Health.

SBAT’s annual average cost of $1,500 per student can save $5,000 to $7,000 in medical expenses per student per year because it significantly reduces asthma symptoms and associated health care costs.

The improvement in health among students participating in SBAT was remarkable, Arcoleo said.

“In one year, for 633 students, we were able to reduce emergency department visits by 49%, urgent care visits by 41%, hospitalizations by 50% and pediatric intensive care unit admissions by 71%,” she explained.

 “Preliminary analyses show that although the program starts out costing about $3,000 per student annually, the cost drops down to only $500 once the school has their program established,” said Arcoleo.
 

Health care savings
Controlled asthma means fewer visits for acute medical care, and this results in tremendous savings on health care expenses. Arcoleo and her team identified these savings for each type of medical visit for asthma care averted:

• Acute care: $100/visit
• Urgent care: $150/visit
• Emergency department: $1,993/visit
• Hospitalization: $14,787/visit
• Pediatric intensive care unit: $46,961/visit

The team also identified these annual savings, which add to over $3.4 million:

• Emergency department visits: $1,006,833
• Hospitalization: $1,210,570
• Pediatric intensive care unit: $1,185,369

Parents credit SBAT with fewer trips to the hospital and less time spent away from work. One family mentioned that they hadn’t needed to make an emergency trip to their health care provider in almost a year.

Reductions in missed class time and behavioral incidents
Preliminary data also show a reduction in missed instructional time and behavioral incidents for students who receive SBAT.

“For the elementary school kids, we decreased their missed instructional time by 16%,” said Arcoleo. “And for the kids in middle school and high school, we decreased their missed instructional time by 25%. Also, behavioral incidents, such as disruptive behavior, fighting and vandalism were reduced by 7%.

“This is important from the standpoint of learning,” she said. “It’s also important for the schools because they get reimbursed by the federal government for attendance. It’s a double benefit.”

Using six years’ worth of data already collected, Arcoleo and her team are now doing a more comprehensive economic evaluation that includes medical costs, staff time and missed work time for caregivers. They expect to publish those findings later in 2025.

Read more on MSUToday.

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