The relationship between asthma, asthma control and economic outcomes in the United States.
OBJECTIVE
Asthma, a serious chronic lung disease affecting approximately 26 million Americans, remains clinical and economic burdens on the healthcare system. Although associations between uncontrolled asthma and poor health outcomes is known, the extent of this impact of uncontrolled asthma on economic outcomes in the United States (US) is unknown. We sought to determine the relationship between asthma, asthma control and economic outcomes in the US.


METHODS
The 2008-2010 Medical Expenditure Panel Surveys were used to estimate the impact of uncontrolled asthma (asthma-related emergency department [ED] visit, use of >3 canisters of quick-relief inhaler in past 3 months or asthma attack in past 12 months) on medical expenditures, utilization and productivity. Estimates were generated using multivariate regression controlling for sociodemographics and comorbidity.


RESULTS
Medical expenditures attributable to asthma were up to $4423 greater for those with markers of uncontrolled asthma compared with those who did not have asthma. Frequency of hospital discharges were up to 4.6-fold greater for those with uncontrolled asthma than those without asthma (p < 0.01), while all others with asthma did not have significantly more discharges. ED visits were up to 1.8-fold greater for those with uncontrolled asthma compared with those without asthma (p < 0.01). Productivity was significantly (p < 0.01) decreased (more likely to be unemployed, more days absent from work and more activity limitations) for those with uncontrolled asthma.


CONCLUSIONS
In recent national data, individuals with asthma and markers of uncontrolled asthma had higher medical expenditures, greater utilization and decreased productivity.
Regis University School of Pharmacy , Denver, CO .
Patrick W
PW
Sullivan
Julia F
JF
Slejko
Vahram H
VH
Ghushchyan
Brandon
B
Sucher
Denise R
DR
Globe
Shao-Lee
SL
Lin
Gary
G
Globe
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000191:economics* / Q000628:therapy; D002648:Child; D017281:Cost of Illness; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult
Cost analyses; economic burden; medical expenditures; productivity; uncontrolled asthma; utilization outcomes