National Jewish Health, Denver, Colorado, USA.
Ann Allergy Asthma Immunol. 2011 Aug;107(2):110-119.e1. doi: 10.1016/j.anai.2011.04.008. Epub 2011 Jun 2.
The cost associated with asthma impairment in children with severe asthma has not been determined.
To assess the asthma cost burden in children with severe or difficult-to-treat asthma based on asthma impairment.
Children aged 6 to 12 years in The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens study with available data at baseline (n = 628), month 12 (n = 385), and month 24 (n = 280) corresponding to the National Heart, Lung, and Blood Institute asthma guidelines' impairment domain were included. Children were categorized as either very poorly controlled (VPC), not well controlled (NWC), or well controlled (WC) and assessed cross-sectionally and longitudinally. Mean total asthma costs based on direct (medication usage, unscheduled office visits, emergency department visits, hospitalizations) and indirect (school/work days lost) asthma costs were assessed.
Mean annual total asthma costs were more than twice as high in the VPC group compared with NWC and WC groups (baseline: $7,846, $3,526, $3,766.44, respectively; month 12: $7,326, $2,959, $2,043, respectively; month 24: $8,879, $3,308, $1,861, respectively (all P < .001). Indirect costs accounted for approximately half the total asthma costs for VPC asthma patients at each time point. Significantly lower costs were observed for patients whose impairment status improved or temporarily improved from VPC after baseline.
The economic burden of severe or difficult-to-treat asthma in children is associated with VPC asthma and improvement in asthma control and is associated with reducing cost. Further attention to patients with poorly controlled asthma, through better management strategies or more effective medications, may significantly reduce this burden of illness.
尚未确定重度哮喘儿童哮喘相关损害的成本。
根据哮喘损害评估重度或治疗困难的哮喘儿童的哮喘成本负担。
纳入了在“哮喘的流行病学和自然史：结局和治疗方案研究”中年龄在 6 至 12 岁之间、基线时有可用数据（n=628）、第 12 个月（n=385）和第 24 个月（n=280）的儿童，对应于国家心肺血液研究所哮喘指南的损害域。根据非常未控制（VPC）、未控制（NWC）或控制（WC）对儿童进行分类，并进行横断面和纵向评估。根据直接（药物使用、非计划性就诊、急诊就诊、住院）和间接（上学/工作天数损失）哮喘成本评估基于哮喘的总成本均值。
与 NWC 和 WC 组相比，VPC 组的年平均总哮喘成本高出两倍多（基线：7846 美元、3526 美元、3766.44 美元；第 12 个月：7326 美元、2959 美元、2043 美元；第 24 个月：8879 美元、3308 美元、1861 美元；所有 P 值均<.001）。间接成本约占 VPC 哮喘患者在每个时间点的总哮喘成本的一半。与基线时 VPC 状态改善或暂时改善的患者相比，观察到成本显著降低。
儿童重度或治疗困难的哮喘的经济负担与 VPC 哮喘以及哮喘控制的改善相关，并与降低成本相关。通过更好的管理策略或更有效的药物，进一步关注控制不佳的哮喘患者，可能会显著降低这种疾病负担。
