Halpern Michael T, Schmier Jordana K, Richner Randel, Guo Chuanfa, Togias Alkis
Exponent Inc., Alexandria, Virginia, USA.
J Asthma. 2004 Feb;41(1):117-26. doi: 10.1081/jas-120026069.
Allergic rhinitis and asthma each require costly medical resource utilization, and the impact of both conditions is believed to be even greater. This retrospective cost of illness study evaluated the impact of allergic rhinitis on asthma medical care resource utilization rates and costs for patients with asthma plus allergic rhinitis vs. patients with asthma alone. Patients with one or more claims for asthma (n=27,398) were identified from a medical claims database from a large, northeastern U.S. health insurance plan (1992-1994). A subset of 9226 patients also had at least one visit for allergic rhinitis. Inpatient, professional service, major medical, and pharmaceutical (prescription medications) claims were examined. Patients with asthma and allergic rhinitis had greater medical utilization and costs than individuals with asthma only. The presence of allergic rhinitis was associated with greater frequencies and costs of prescriptions for all asthma-related medications evaluated in the study. Patients with both conditions were also more likely to receive care from medical specialists and less likely to be in managed care. Controlling for these factors, allergic rhinitis was still associated with an increase (P<0.0001) in annual costs of more than dollars 350. Allergic rhinitis in patients with asthma nearly doubles annual medical resource utilization and costs and is associated with increased utilization of asthma-related medications. Based on use of asthma medications, patients with concomitant allergic rhinitis can be regarded as having more severe asthma than do those without allergic rhinitis. Physicians should assess asthma patients for symptoms of allergic rhinitis to improve asthma treatment.
变应性鼻炎和哮喘各自都需要消耗高昂的医疗资源，而且据信这两种疾病的影响更为巨大。这项回顾性疾病成本研究评估了变应性鼻炎对哮喘加变应性鼻炎患者与单纯哮喘患者的哮喘医疗护理资源利用率及成本的影响。从美国东北部一个大型健康保险计划（1992 - 1994年）的医疗理赔数据库中识别出有一项或多项哮喘理赔记录的患者（n = 27398）。9226名患者的一个子集也至少有一次变应性鼻炎就诊记录。对住院、专业服务、重大医疗和药品（处方药）理赔进行了检查。患有哮喘和变应性鼻炎的患者比仅患有哮喘的个体有更高的医疗利用率和成本。变应性鼻炎的存在与研究中评估的所有哮喘相关药物的处方频率和成本增加有关。同时患有这两种疾病的患者也更有可能接受医学专科医生的治疗，而接受管理式医疗的可能性较小。在控制这些因素后，变应性鼻炎仍与每年成本增加超过350美元相关（P < 0.0001）。哮喘患者中的变应性鼻炎使每年的医疗资源利用率和成本几乎翻倍，并与哮喘相关药物的使用增加有关。基于哮喘药物的使用情况，伴有变应性鼻炎的患者可被视为比没有变应性鼻炎的患者患有更严重的哮喘。医生应评估哮喘患者是否有变应性鼻炎症状，以改善哮喘治疗。
