Kim Sae-Hoon, Kim Tae-Wan, Kwon Jae-Woo, Kang Hye-Ryun, Lee Yong-Won, Kim Tae-Bum, Kim Sang-Heon, Park Heung-Woo, Park Sung-Woo, Chang Yoon-Seok, Cho You-Sook, Park Jung-Won, Cho Young-Joo, Yoon Ho-Joo, Cho Sang-Heon, Choi Byoung-Whui, Moon Hee-Bom, Min Kyung-Up
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
J Asthma. 2012 Apr;49(3):303-9. doi: 10.3109/02770903.2011.641046. Epub 2011 Dec 21.
The prevalence of asthma is increasing, and asthma causes considerable socioeconomic burden worldwide. Few studies have been conducted to evaluate the risk factors associated with economic cost of asthma in Korea. This study evaluated asthma cost according to severity, control, and patient factors in Korean tertiary hospitals.
Direct and indirect costs were assessed in physician-diagnosed adult asthmatics recruited from eight tertiary hospitals in Korea. Official direct medical costs were derived from the analysis of 1-year expenditures related to hospital care utilization and asthma medication. Nonofficial medical costs, nonmedical direct costs, and indirect costs were investigated using a questionnaire designed specifically for the study.
A total of 314 patients with persistent asthma were recruited. Both direct and indirect costs were significantly higher for patients with severe persistent asthma than for those with mild and moderate persistent asthma ($2214 vs. $871 and $978, p < .001; $2927 vs. $490 and $443, p < .001, respectively). Costs of asthma increased significantly in poorly controlled compared with somewhat controlled and well-controlled asthma ($7009.8 vs. $2725.3 vs. $1517.3, respectively; p < .001). After stratification for severity, a significant cost increase in the poorly controlled asthma group was observed only for indirect costs and not for direct costs. A multivariate analysis showed that female gender was a risk factor for increased indirect costs.
The burden of asthma was higher both for patients with severe persistent asthma and for patients with poorly controlled asthma. More effective strategies are needed to improve control status, particularly targeting patients with severe asthma.
哮喘的患病率正在上升，并且哮喘在全球造成了相当大的社会经济负担。在韩国，很少有研究评估与哮喘经济成本相关的风险因素。本研究在韩国三级医院中，根据哮喘的严重程度、控制情况和患者因素评估了哮喘成本。
对从韩国八家三级医院招募的经医生诊断的成年哮喘患者的直接和间接成本进行了评估。官方直接医疗成本来自对与医院护理利用和哮喘药物相关的1年支出的分析。非官方医疗成本、非医疗直接成本和间接成本通过专门为该研究设计的问卷进行调查。
共招募了314例持续性哮喘患者。重度持续性哮喘患者的直接和间接成本均显著高于轻度和中度持续性哮喘患者（分别为2214美元对871美元和978美元，p <.001；2927美元对490美元和443美元，p <.001）。与控制较好和控制良好的哮喘相比，控制不佳的哮喘成本显著增加（分别为7009.8美元对2725.3美元对1517.3美元；p <.001）。在按严重程度分层后，仅在控制不佳的哮喘组中观察到间接成本显著增加，而直接成本未增加。多变量分析表明，女性是间接成本增加的一个风险因素。
重度持续性哮喘患者和控制不佳的哮喘患者的哮喘负担更高。需要更有效的策略来改善控制状况，特别是针对重度哮喘患者。
