Direct and indirect costs of asthma in school-age children

Li Yan Wang, Yuna Zhong, Lani Wheeler, Li Yan Wang, Yuna Zhong, Lani Wheeler

Abstract

Introduction: Asthma is one of the most common chronic diseases of childhood and is the most common cause of school absenteeism due to chronic conditions. The objective of this study is to estimate direct and indirect costs of asthma in school-age children.

Methods: Using data from the 1996 Medical Expenditure Panel Survey, we estimated direct medical costs and school absence days among school-age children who had treatment for asthma during 1996. We estimated indirect costs as costs of lost productivity arising from parents' loss of time from work and lifetime earnings lost due to premature death of children from asthma. All costs were calculated in 2003 dollars.

Results: In 1996, an estimated 2.52 million children aged five to 17 years received treatment for asthma. Direct medical expenditure was 1009.8 million dollars (401 dollars per child with asthma), including payments for prescribed medicine, hospital inpatient stay, hospital outpatient care, emergency room visits, and office-based visits. Children with treated asthma had a total of 14.5 million school absence days; asthma accounts for 6.3 million school absence days (2.48 days per child with asthma). Parents' loss of productivity from asthma-related school absence days was 719.1 million dollars (285 dollars per child with asthma). A total of 211 school-age children died of asthma during 1996, accounting for 264.7 dollars million lifetime earnings lost (105 dollars per child with asthma). Total economic impact of asthma in school-age children was 1993.6 million dollars (791 dollars per child with asthma).

Conclusion: The economic impact of asthma on school-age children, families, and society is immense, and more public health efforts to better control asthma in children are needed.

References

    1. Measuring childhood asthma prevalence before and after the 1997 redesign of the National Health Interview Survey — United States. MMWR Morb Mortal Wkly Rep. 2000;49:908–911.
    1. Akinbami LJ, Schoendorf KC. Trends in childhood asthma: prevalence, health care utilization, and mortality. Pediatrics. 2002;110(2 Pt 1):315–322.
    1. American Lung Association. Trends in asthma morbidity and mortality (Internet) New York: The Association; Mar, 2003. Available from: URL: .
    1. Weiss KB, Gergen PJ, Hodgson TA. An economic evaluation of asthma in the United States. N Engl J Med. 1992;326:862–866.
    1. Weiss KB, Sullivan SD, Lyttle CS. Trends in the cost illness for asthma in the United States, 1985–1994. J Allergy Clin Immunol. 2000:493–499.
    1. Lozano P, Sullivan SD, Smith DH, Weiss KB. The economic burden of asthma in US children: estimates from the National Medical Expenditure Survey. J Allergy Clin Immunol. 1999;104:957–963.
    1. Fowler MG, Davenport MG, Garg R. School functioning of US children with asthma. Pediatrics. 1992;90:939–944.
    1. Silverstein MD, Mair JE, Katusic SK, Wollan PC, O'Connell EJ, Yunginger JW. School attendance and school performance: a population-based study of children with asthma. J Pediatr. 2001;139:278–283.
    1. Haddix AC, Teutsch SM, Corso PS. Prevention effectiveness: a guide to decision analysis and economic evaluation. New York: Oxford University Press; 2003.
    1. U.S. Department of Health and Human Services. International classification of diseases, ninth revision, clinical modification. Public Health Service; Washington (DC): 1988.
    1. Little RJA, Rubin DB. Statistical analysis with missing data. John Wiley & Sons, Inc; New York: 1987.
    1. Shah BV, Barnwell BG, Bieler GS. SUDAAN user's manual: software for analysis of correlated data, release 7.5. Research Triangle Institute; Research Triangle Park (NC): 1997.
    1. Cohen JW, Krauss NA. Spending and service use among people with the fifteen most costly medical conditions, 1997 Health Aff. 2003;22:129–138.
    1. Lewis CE, Rachelefsky G, Lewis MA, de la Sota A, Kaplan M. A randomized trial of A.C.T. (asthma care training) for kids. Pediatrics. 1984;74(4):478–486.
    1. Kelly CS, Morrow AL, Shults J, Nakas N, Strope GL, Adelman RD. Outcomes evaluation of a comprehensive intervention program for asthmatic children enrolled in Medicaid. Pediatrics. 2000;105(5):1029–1035.
    1. Sullivan SD, Weiss KB, Lynn H, Mitchell H, Kattan M, Gergen PJ, et al. The cost-effectiveness of an inner-city asthma intervention for children. J Allergy Clin Immunol. 2002;110:576–581.
    1. Kelly CS, Andersen CL, Pestian JP, Wenger AD, Finch AB, Strope GL, et al. Improved outcomes for hospitalized asthmatic children using a clinical pathway. Ann Allergy Asthma Immunol. 2000;84:509–516.
    1. Axlrod RC, Zimbro KS, Chetney RR, et al. A disease management program utilizing life coaches for children with asthma J Clin Outcomes Manag. 2001;8:38–42.
    1. Spencer GA, Atav SA, Johnston Y, Harrigan JF. Managing childhood asthma: the effectiveness of the open airways for schools program Fam Community Health. 2000;23:20–30.
    1. Kelly CS, Shield SW, Gowen MA, Jaganjac N, Andersen CL, Strope GL. Outcomes analysis of a summer asthma camp. J Asthma. 1998;35:165–171.
    1. Georgiou A, Buchner DA, Ershoff D, Blasko KM, Goodman LV, Feigin J. The impact of a large-scale population-based asthma management program on pediatric asthma patients and their caregivers. Ann Allergy Asthma Immunol. 2003;90:308–315.

Source: PubMed

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