Cost Effectiveness Analysis of a Randomized Control Trial of q3h vs. q4h Albuterol as Discharge Criteria From the Hospital for Pediatric Asthma Exacerbations
Cost Effectiveness Analysis of a Randomized Control Trial of q3h vs. q4h Albuterol as Discharge Criteria From the Hospital for Pediatric Asthma Exacerbations
Asthma is the most common chronic condition among children, and the third leading reason for
 hospitalization of children in the United States. It exerts a large healthcare burden on the
 US with estimated annual direct healthcare cost of approximately $50.1 billion with indirect
 costs of $5.9 billion.

 Asthma is characterized by airway inflammation and airway constriction. Albuterol and other
 betaagonists are first line standard of care for acute exacerbations and provide short acting
 smooth muscle relaxation and subsequent airway opening. The frequency of albuterol
 administration is dependent on the severity of the exacerbation. For hospitalized patients
 here at Children's Memorial Hermann (CMHH), patients may receive nebulized albuterol
 continuously or if the exacerbation is not as severe, receive albuterol intermittently.
 Intermittent albuterol frequency ranges from every two hour treatments, every three hour
 (q3h) treatments, or every four hour (q4h) treatments. As patients recover from their acute
 exacerbation, their frequency of albuterol administration is progressively titrated along
 this continuum. Expert consensus uses q4h albuterol as discharge criteria from the hospital.
 However, recent QI initiatives have studied the effect of q3h treatments as the discharge
 cutoff with no reported changes in safety or harm. There are no randomized controlled trials
 available. Furthermore, there are no economic evaluations available to see if costs saved by
 decreasing the length of hospital care are merely being shifted to subsequent clinic or
 emergency room care costs.

 We aim to conduct a randomized control trial to compare q3h vs. q4h albuterol as hospital
 discharge criteria for patients admitted for acute asthma exacerbations. We also propose to
 conduct a costeffectiveness analysis of the trial. If our hypothesis that q3h albuterol is
 safe and as effective as q4h albuterol as discharge criteria, we would be able to argue for a
 new standard of care that is more costeffective for this very costly and common disease of
 children in the United States
Inclusion Criteria:

 -  Children with Primary Reason for Hospitalization of Asthma Exacerbation

 Exclusion Criteria:

 -  Those that never needed q3h albuterol treatments