In an intent-to-treat analysis , comprehensive care decreased both the rate of children with a serious illness ( 10 per 100 child-years vs 22 for usual care ; rate ratio [ RR ] , 0.45 [ 95 % CI , 0.28-0 .73 ] ) , and total hospital and clinic costs ( $ 16,523 vs $ 26,781 per child-year , respectively ; cost ratio , 0.58 [ 95 % CI , 0.38-0 .88 ] ) .