title: Costs associated with workdays lost and utilization of health care resources because of asthma in daily clinical practice in Spain.
abstract: BACKGROUND
  Asthma is associated with high indirect costs due to lower work productivity and higher absenteeism and presenteeism.
  
  
  OBJECTIVE
  To study loss of productivity measured using the lost workday equivalent (LWDE) index and health care utilization in asthmatics depending on age, geographical location, time period, severity, and level of asthma control.
  
  
  METHODS
  In this cross-sectional, observational, epidemiological multicenter study, 120 allergists nationwide were asked to select asthmatic patients aged 18 to 65 years who were evenly distributed according to the 4 levels of asthma severity (Global Initiative on Asthma) during 3 different seasons. The participants collected sociodemographic data, spirometry values, Asthma Control Test (ACT) score, health care utilization data, perceived stress according to the Impact on Work Productivity Index (IMPALA, indice del Impacto de la Enfermedad en la Productividad Laboral), and score on the Sheehan disability scale. The LWDE index was used to measure the number of workdays lost and the number of workdays with asthma symptoms combined with the percentage for average performance at work.
  
  
  RESULTS
  The study sample comprised 1098 patients (58.7% females; 48.5% aged 18-40 and 51.5% aged 41-65). According to the ACT score, disease was uncontrolled in 57.6% of patients, well controlled in 32.8%, and totally controlled in 9.6%. The mean cost due to workdays lost was Euro 285.81/patient/mo (95% CI, Euro 252.71-318.92). Indirect costs were significantly higher in older patients (41-65 years, Euro 405.08; 95% CI, 348.97-461.19), patients with more severe disease (Euro 698.95; 95% CI, 588.63-809.27), and patients with more poorly controlled asthma (Euro 466.86; 95% CI, Euro 414.39-519.33). The average cost of health care units per patient for each 3-month period was Euro1317.30 (95% CI, Euro 1151.34-Euro 1483.26). Indirect costs were significantly higher in older patients (Euro 2104.00 in patients aged 18-40 vs Euro 3301.55 in patients aged 41-65), in northern and central regions, in severe disease (Euro 2921.63), and in more poorly controlled asthma (Euro 1799.42).
  
  
  CONCLUSIONS
  Our findings could prove useful for physicians and health care providers.
authors: Clínica de Asma y Alergia Dres. Ojeda, Madrid, Spain.
authors: P
authors: P
authors: Ojeda
authors: V
authors: V
authors: Sanz de Burgoa
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000191:economics* / Q000453:epidemiology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000191:economics*; D004526:Efficiency; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology