title: An employer perspective on annual employee and dependent costs for pediatric asthma.
abstract: BACKGROUND
  The burden of pediatric asthma on parents' health care costs is not well described.
  
  
  OBJECTIVE
  To evaluate direct and indirect health care costs of employees with children with asthma (asthma cohort) compared with employees with children without asthma (control cohort).
  
  
  METHODS
  Retrospective analysis of 2001-2007 employer data including employee medical and pharmacy claims, payroll, work absence, demographics, and dependent medical and pharmacy claims. Asthma diagnosis or pharmacy claims for asthma controller medications were used to identify employees with dependents younger than 12 years for the asthma cohort. Controls were identified based on dependent age and lack of an asthma diagnosis or pharmacy claim for a controller medication. All costs were calculated using 2-part regression models that controlled for demographics, job information, Charlson Comorbidity Index, and region. Costs were calculated for employee health care, prescriptions, sick leave, short- and long-term disability, and workers' compensation and dependent health care and prescriptions. Costs were compared for employees with children aged 0 through 3 years, 4 through 7 years, 8 through 11 years, and younger than 12 years.
  
  
  RESULTS
  Data were available for 11,794 asthma cohort employees and 64,812 controls. Statistically significant annual cost differences were identified for employee health care ($154, P < .001), prescriptions ($95, P < .001), sick leave (-$41, P < .001), short-term disability (-$41, P = .008), dependent health care ($862, P < .001), and prescriptions ($534, P < .001).
  
  
  CONCLUSIONS
  Pediatric asthma is associated with significant additional health care and prescription costs for both employees and dependents.
authors.affiliation: Human Capital Management Services, Paso Robles, California 93446, USA. nathan_kleinman@hcmsgroup.com
authors.forename: Nathan L
authors.initials: NL
authors.lastname: Kleinman
authors.forename: Richard A
authors.initials: RA
authors.lastname: Brook
authors.forename: Sulabha
authors.initials: S
authors.lastname: Ramachandran
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D001249:Asthma / Q000188:drug therapy / Q000191:economics*; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D003695:Delivery of Health Care / Q000191:economics; D017049:Employer Health Costs / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007342:Insurance Benefits / Q000191:economics; D008297:Male; D055553:Prescription Drugs / Q000191:economics; D044469:Racial Groups / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018582:Sick Leave / Q000191:economics; D014481:United States; D014942:Workers' Compensation / Q000191:economics
chemical_list: D000305:Adrenal Cortex Hormones; D000319:Adrenergic beta-Antagonists; D055553:Prescription Drugs