Public health · Cost-effectiveness
A CDC-approved, societal-perspective cost-effectiveness analysis of the stock albuterol program across 167 Jefferson County Public Schools. Its findings supported expanding the program beyond Jefferson County.
- Client
- Kentucky Department for Public Health, Kentucky Asthma Management Program
- Role
- Primary Evaluator, CDC Cooperative Agreement NUE1EH001372
- Period
- 2023 – 2025
167
schools in the evaluation
14
data sources integrated
9
consortium organizations briefed
5
research staff directed
The challenge
Stock albuterol lets a school nurse treat an asthma attack on the spot, even when a student's own inhaler is not at school. The state needed to know whether that is worth funding. The answer had to count medical costs, missed school days, and the work caregivers lose when a child is sent home or hospitalized.
What we did
- 01Authored the CDC-approved evaluation protocol, logic model and a 14-source data plan.
- 02Designed and built a retrospective, societal-perspective cost-effectiveness analysis estimating the incremental cost per school day missed avoided and per hospitalization avoided, including caregiver work loss.
- 03Integrated Medicaid claims, BRFSS, MEPS, ESSENCE syndromic surveillance, hospitalization and school data, all held under HIPAA, FERPA and state data-sharing agreements.
- 04Ran ZIP-code and race-stratified analyses of Medicaid-enrolled youth to locate gaps in asthma control, emergency department use and access to preventive therapy.
- 05Parameterized the model from a targeted literature review, then completed sensitivity analysis and base-year cost standardization.
- 06Directed five research staff within a team of epidemiologists, school nurses and CDC grant officers.
Asthma prevalence among students, by race and ethnicity
Percent of students. Documented in the Kentucky Asthma Management Program evaluation.
| Group | Prevalence |
|---|---|
| African American students | 14.0% |
| Hispanic students | 13.5% |
| White students | 7.9% |
The evaluation stratified Medicaid-enrolled youth by ZIP code and race to show where asthma control, emergency visits and access to preventive therapy fell short, so funding could follow need.
The outcome
- Results presented to state leadership, the CDC, school health coordinators and a nine-organization consortium. The evidence supported expanding the program beyond Jefferson County.
- Recommendations to Medicaid and chronic-disease program leadership on sustaining funding and reimbursement.
- A three-part workshop series on economic evaluation methods for state agencies and chronic-disease coalitions, plus Power BI dashboards for state and federal stakeholders.
- Final report delivered October 2025. A white paper revised to CHEERS 2022 reporting standards is in preparation.
Next engagement
A Phase III program built for payers as well as regulators
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Tell us about the launch, the coverage question or the program that needs to show its value. We will tell you what evidence it needs, and what it can do without.