To determine the clinical outcomes and cost-effectiveness of 3 inhaled corticosteroid (ICS) delivery options for children with asthma treated in and discharged from the emergency department (ED).

A hypothetical cohort of children with asthma being discharged from the ED introduced into each arm of the decision tree analysis.

A cost-effectiveness decision analysis model was designed by using a decision tree to compare 3 ED-based ICS delivery options: (1) usual care (recommending outpatient follow-up), (2) prescribe (uniformly prescribing ICS), and (3) dispense (uniformly dispensing ICS). Accounting for expected follow-up rates, prescription filling, and medication compliance, the investigators compared projected rates of ED relapse visits and hospitalizations within 1 month of ED visits across all 3 arms; 100 children in each group. Direct and indirect costs were compared.

The model predicts that the rate of return to ED per 100 patients within 1 month of ED visit was 10.6 visits for the...

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