Effect of Allergic Rhinitis on the Use and Cost of Health Services by Children with Asthma
1
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Purpose: Allergic rhinitis (AR) is common among children with asthma and exacerbates asthma symptoms. To assess the incremental utilization and cost of asthma-related health services due to concomitant AR among asthmatic children. Materials and Methods: Asthma-related claims were extracted from the Korean National Health Insurance (NHI) claims database, which covers 97% of the population. Per-capita utilization and costs of asthma-related services were determined from the societal perspective. Results: Of 319,714 children (1-14 years old) with chronic asthma in 2003, 195,026 had concomitant AR (prevalence 610 per 1,000 asthmatic children). Children with AR had 1.14 times more outpatient visits, 1.30 times more emergency department (ED) visits, and 1.49 times more hospitalizations than children without AR. More children with AR used general hospitals (7.17%) than children without AR (3.23%). The ratios of unit pharmaceutical costs per outpatient visit, ED visit, and admission between children with and without AR were 1.27, 1.20, and 1.14. Total annual expenditure combining direct health care, transportation, and caregivers' costs, were $273 and $217 for children with and without AR, respectively. Conclusion: Health service utilization and costs for asthma were greater for asthmatic children with AR. More frequent ED visits and admissions among asthmatic children with AR suggest poorer control and more frequent exacerbations. Higher unit cost of pharmaceuticals during visits, tendency to receive asthma care from a higher-level facility, and greater risk of ED visit or admission all contributed to the additional economic burden of AR.
Abstract
Purpose: Allergic rhinitis (AR) is common among children with asthma and exacerbates asthma symptoms. To assess the incremental utilization and cost of asthma-related health services due to concomitant AR among asthmatic children. Materials and Methods: Asthma-related claims were extracted from the Korean National Health Insurance (NHI) claims database, which covers 97% of the population. Per-capita utilization and costs of asthma-related services were determined from the societal perspective. Results: Of 319,714 children (1-14 years old) with chronic asthma in 2003, 195,026 had concomitant AR (prevalence 610 per 1,000 asthmatic children). Children with AR had 1.14 times more outpatient visits, 1.30 times more emergency department (ED) visits, and 1.49 times more hospitalizations than children without AR. More children with AR used general hospitals (7.17%) than children without AR (3.23%). The ratios of unit pharmaceutical costs per outpatient visit, ED visit, and admission between children with and without AR were 1.27, 1.20, and 1.14. Total annual expenditure combining direct health care, transportation, and caregivers' costs, were $273 and $217 for children with and without AR, respectively. Conclusion: Health service utilization and costs for asthma were greater for asthmatic children with AR. More frequent ED visits and admissions among asthmatic children with AR suggest poorer control and more frequent exacerbations. Higher unit cost of pharmaceuticals during visits, tendency to receive asthma care from a higher-level facility, and greater risk of ED visit or admission all contributed to the additional economic burden of AR.
참고문헌 (20)
- Chung F, "Assessing the burden of respiratory disease in the UK", Respir Med, 96, pp.963~975 (2002)
- Strachan D, "Worldwide variations in prevalence of symptoms of allergic rhinoconjunctivitis in children: the International Study of Asthma and Allergies in Childhood (ISAAC)", Pediatr Allergy Immunol, 8, pp.161~176 (1997)
- Bousquet J, "Aria Workshop Group; World Health Organization. Allergic rhinitis and its impact on asthma", J Allergy Clin Immunol, 108(5), pp.s147~s334 (2001)
- Schoenwetter WF, "Economic impact and quality-sof-life burden of allergic rhinitis", Curr Med Res Opin, 20, pp.305~317 (2004)
- Blaiss MS, "social, and economic costs of allergic rhinitis", Allergy Asthma Proc, 21, pp.7~13 (2000)
- Weiss KB, "6. Weiss KB, Sullivan SD. The health economics of asthma and rhinitis. I. Assessing the economic impact", J Allergy Clin Immunol, 107, pp.3~8 (2001)
- Yawn BP, "Allergic rhinitis inRochester, Minnesota residents with asthma: frequency and impact on health care charges", J Allergy Clin Immunol, 103, pp.54~59 (1999)
- Grupp-Phelan J, "Health care utilization and cost in children with asthma and selected comorbidities", Asthma, 38, pp.363~373 (2001)
- Thomas M, "Asthma-related health care resource use among asthmatic children with and without concomitant allergic rhinitis", Pediatrics, 115, pp.129~134 (2005)
- Birnbaum HG, "Using healthcare claims data for outcomes research and pharmacoeconomic analyses", Pharmacoeconomics, 16, pp.1~8 (1999)
- Crown WH, "Seasonal versus perennial allergic rhinitis: drug and medical resource use patterns", Value Health, 6, pp.448~456 (2003)
- Jung HJ, "Estimating non-covered medical cost", Health Insurance Forum, 1, pp.73~97 (2002)
- Yang BM, "Developing criteria for estimating standard costs used in economic evaluation studies for medicines (technical report: Korean)", pp.149~ (2004), Health Insurance Review Agency
- Drummond MF, "Chapter 7. Cost-benefit analysis. In: Methods for the economic evaluation of health care programmes", pp.216~ (2005), Oxford University Press
- "Age- and gender-specific participation rate to labor market"[URL]
- "Statistics for wage structure"[URL]
- Korea YWCA, "Personal talk with Korea YWCA administrator", ~ (2004)
- Yang BM, "Developing criteria for estimating standard costs used in economic evaluation studies for medicines (technical report: Korean)", Health Insurance Review Agency, pp.152~153 (2004)
- Garcia-Garcia ML, "Montelukast, compared with fluticasone, for control of asthma among 6- to 14-year-old patients with mild asthma: The MOSAIC study", Pediatrics, 116, pp.360~369 (2005)
- Kang HY, "Economic burden of smoking in Korea", Tob Control, 12, pp.37~44 (2003)