Environmental Asthma Trigger Home Assessment Program

About the Program

Category: Health (Best in Category)

Year: 2013

The Wake County Environmental Health & Safety Division, Wake County Environmental Services Department has implemented a program to improve asthma control in children through home assessment visits that identify and mitigate indoor environmental asthma triggers. The program has saved the county more than $185,000 by lowing medical costs from decreased hospitalizations and emergency department visits. The key strategies consist of: identifying potential environmental asthma triggers in children’s homes; providing families with education and materials (e.g. pillow case and mattress covers) to limit exposure to asthma triggers; providing information to landlords on the presence of asthma triggers in their units; providing contact information for agencies that can help families when property owners will not repair facility issues; educating families about the proper use of prescribed asthma medications and devices; and encouraging follow up with a primary care provider. The medical education and materials are provided by a nurse care manager with Community Care of Wake and Johnston Counties, a medical home care management program. The home assessment for asthma triggers is done by a Wake County Environmental Health Specialist. The nurse schedules the home assessments based on recent asthma-related hospitalizations, emergency department visits, or referrals from primary care providers for children on Medicaid. The partner agencies consist of Wake County Environmental Services, Wake County Human Services, and Community Care of Wake and Johnston Counties. The improved outcomes consist of a reduction in the child’s asthma-related medical costs from decreased hospitalizations and emergency department visits. A total of 476 home assessments have been done. For the 258 patients with complete one year pre and post data, a total cost savings of $185,253 has been achieved or about $720 per patient. In addition the program has helped to connect client families with agencies that regulate rental housing to address other public health issues like bedbugs and to address building safety issues like fire hazards.