Title:
ECONOMIC JUSTIFICATION FOR PROACTIVE REMEDIATION OF PRIVATE HOMES OF HIGH-USE ASTHAMATICS

Authors:
C. Hostland, G. Lovegrove, D. Roberts

Abstract:
Background The direct burden on North America health care systems attributable to respiratory disease including specific asthmatic effects is in excess of $20 billion dollars yearly. It exceeds $61 billion dollars including indirect and external costs, with asthma rates continuing to climb. Purpose The purpose of this paper includes: 1) exposing the reversible economic impact of mould and dampness affected high-use asthmatics on the public health care system; 2) a social cost benefit analysis on patient and societal impact from mould and dampness and its reduction through remediation of residential indoor environments; and 3) a proposal for proactively addressing the significant patient cost and reversing the health impact of this demographic through a health care environmental asthma prevention program. Methods Literature review and a survey sampling of health care professionals was conducted 2012-2014 to develop and isolate the more significant public health care system costs related to untreated damp and mouldy indoor home environments of the high-use asthmatic to confirm prevention viability. A social cost benefit analysis was conducted using risk assessment. Results The total yearly public health care system and societal cost impact due to indoor mould and dampness to British Columbians is $153.3 million, for slightly over 4,400 asthmatics, which extrapolates to $1.84 billion in Canada and $ 18.4 billion in the United States. Savings accrued through program implementation are $97.4 million, a 63.5% reduction, after the first year in B.C. which projects to $ 1.17 billion in Canada and $11.7 billion for the U.S. The reduction in public health care system costs alone is 72% or $31.7 million in BC, projecting to $380 million in Canada, and $3.8 billion in the U.S. Conclusions The results support an economic justification towards developing a prevention public health care system approach to residential mould and dampness.