title: Direct medical cost of Thai pediatric asthma management: a pilot study.
abstract: BACKGROUND
  The prevalence of asthma in Bangkok increased steadily over the last couple of decades and warrants an assessment of the costs associated with its treatment, particularly in the case of children.
  
  
  OBJECTIVE
  To estimate the direct medical costs of asthma care in children at the Allergy unit of the Department of Pediatrics, Ramathibodi hospital.
  
  
  METHODS
  In this retrospective study, we included asthmatic children aged less than 20 year-old having visited the allergy unit at least 4 times in 12 months between January and December, 2011. Cost data, retrieved from the allergy unit electronic database included billing invoices of inpatient care, outpatient and emergency room visits. From this dataset we estimated drug costs, physician and nursing services, diagnostic tests and procedures, supplies and room charges, and assessed an overall asthma-related direct medical cost.
  
  
  RESULTS
  Ninety-seven asthmatic children (aged 11.5 ± 3.7 years) were included in the study. Annual median direct medical cost was 8,537.9 Baht or 278 USD per patient. Annual direct medical cost was the highest in patients younger than 5 years old (p < 0.001). Moreover, expenses of patients who had at least one exacerbation increased significantly compared to patients without exacerbation (p = 0.02). Furthermore, direct medical cost was the highest when patients had exacerbation requiring hospitalization (p = 0.03).
  
  
  CONCLUSIONS
  Cases of patients having asthma exacerbation or being diagnosed with asthma before 5 years of age were associated with higher treatment expenses. Policies developed to achieve asthma control and prevention should identify young children and patients presenting risk factors for asthma exacerbation as high risk groups deserving particular attention.
authors.affiliation: Division of Pediatric Allergy/Immunology/ Rheumatology, Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Pongtong
authors.initials: P
authors.lastname: Puranitee
authors.forename: Wasu
authors.initials: W
authors.lastname: Kamchaisatian
authors.forename: Wiparat
authors.initials: W
authors.lastname: Manuyakorn
authors.forename: Soamarat
authors.initials: S
authors.lastname: Vilaiyuk
authors.forename: Orawin
authors.initials: O
authors.lastname: Laecha
authors.forename: Oraluck
authors.initials: O
authors.lastname: Pattanaprateep
authors.forename: Suwat
authors.initials: S
authors.lastname: Benjaponpitak
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D010865:Pilot Projects; D012189:Retrospective Studies