Effect of asthma exacerbations on health care costs among asthmatic patients with moderate and severe persistent asthma.

MedStar author(s):
Citation: Journal of Allergy & Clinical Immunology. 129(5):1229-35, 2012 May.PMID: 22326484Institution: MedStar Washington Hospital CenterDepartment: Medicine/Pulmonary-Critical CareForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, Non-U.S. Gov'tSubject headings: *Asthma/ec [Economics] | *Asthma/pp [Physiopathology] | *Disease Progression | *Drug Costs | Adolescent | Adult | Asthma/ep [Epidemiology] | Child | Comorbidity | Cost of Illness | Female | Follow-Up Studies | Humans | Male | Mental Disorders/ep [Epidemiology] | Middle Aged | Pneumonia/ep [Epidemiology] | Sinusitis/ep [Epidemiology] | United States | Young AdultYear: 2012Local holdings: Available online from MWHC library: 1994 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 0091-6749
Name of journal: The Journal of allergy and clinical immunologyAbstract: BACKGROUND: Health care costs increase in patients with more severe asthma, but the effect of asthma exacerbations on costs among patients with more severe asthma has not been quantified.CONCLUSIONS: Patients with moderate/severe persistent asthma who had exacerbations had higher total and asthma-related health care costs than those without exacerbations. Moreover, controller medication use was higher in patients with exacerbations. Copyright 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.METHODS: Patients who had an asthma diagnosis (International Classification of Diseases-ninth revision-Clinical Modification code 493.x), were 12 to 64 years old, and were receiving controller therapy were identified from a large administrative claims database. Patients were categorized as having moderate/severe persistent asthma and were further evaluated for exacerbations during a 12-month exacerbation identification period. Patients with 1 or more exacerbations (asthma-related inpatient or emergency department visit or corticosteroid prescription) were matched to patients without exacerbations on demographic characteristics and asthma severity. Total and asthma-related health care costs during the 1-year study period after the exacerbation index date were calculated.OBJECTIVE: This study compared direct health care costs between patients with moderate/severe persistent asthma with and without exacerbations.RESULTS: Patients with exacerbations had significantly higher total health care costs (All authors: Bergman R, Birnbaum HG, Colice GL, Ivanova JI, McLaurin K, Silverman RAFiscal year: FY2012Digital Object Identifier: Date added to catalog: 2013-09-17
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 22326484 Available 22326484

Available online from MWHC library: 1994 - present, Available in print through MWHC library: 1999 - 2006

BACKGROUND: Health care costs increase in patients with more severe asthma, but the effect of asthma exacerbations on costs among patients with more severe asthma has not been quantified.

CONCLUSIONS: Patients with moderate/severe persistent asthma who had exacerbations had higher total and asthma-related health care costs than those without exacerbations. Moreover, controller medication use was higher in patients with exacerbations. Copyright 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

METHODS: Patients who had an asthma diagnosis (International Classification of Diseases-ninth revision-Clinical Modification code 493.x), were 12 to 64 years old, and were receiving controller therapy were identified from a large administrative claims database. Patients were categorized as having moderate/severe persistent asthma and were further evaluated for exacerbations during a 12-month exacerbation identification period. Patients with 1 or more exacerbations (asthma-related inpatient or emergency department visit or corticosteroid prescription) were matched to patients without exacerbations on demographic characteristics and asthma severity. Total and asthma-related health care costs during the 1-year study period after the exacerbation index date were calculated.

OBJECTIVE: This study compared direct health care costs between patients with moderate/severe persistent asthma with and without exacerbations.

RESULTS: Patients with exacerbations had significantly higher total health care costs ( 223 vs 011, P< .0001) and asthma-related costs ( 740 vs 47, P< .0001). The cost differences remained significant after controlling for patient differences by using multivariate models. Patients with exacerbations (n= 3830) had higher rates of sinusitis, allergy-related diagnoses or medications, pneumonia, and mental disorders and higher average Charlson Comorbidity Index scores at baseline. Patients with exacerbations filled their prescriptions for controllers more often and had higher asthma-related drug costs.

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