The Economic Burden of Asthma in the United States, 2008-2013
The Economic Burden of Asthma in the United States, 2008-2013
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DOI：
10.1513/annalsats.201703-259oc
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发表时间：
2018-03-01
影响因子：
8.3
通讯作者：
Garbe, Paul
中科院分区：
文献类型：
--
作者：
Nurmagambetov, Tursynbek;Kuwahara, Robin;Garbe, Paul
基本原理：哮喘是一种慢性疾病，影响生活质量，工作和学校的生产力以及医疗保健的使用;它可能导致死亡。测量哮喘的当前经济负担提供了关于哮喘对社会影响的重要信息。这些信息可以用来作出明智的决定，分配有限的公共卫生resources.Objectives：在本文中，我们提供了一个全面的方法来估计目前的患病率，医疗费用，缺勤（错过工作和上学的日子）的成本，并归因于哮喘的死亡率从国家的角度来看。此外，我们估计哮喘的增量医疗费用与几个重要因素，包括种族/民族，教育，贫困，和保险状况的关联：数据的主要来源是2008-2013年的医疗支出面板调查的家庭组成部分。我们将哮喘治疗定义为至少有一次与哮喘相关的医疗或药物接触或索赔。对于主要的分析，我们采用两部分回归模型来估计哮喘相关的年度人均增量医疗成本和负二项模型来估计与asthene.Results相关的缺勤率：在213，994人的合并样本中，10，237人治疗哮喘（患病率，4.8%）。哮喘的年度人均增量医疗成本为3，266美元（2015年美元），其中1，830美元用于处方药，640美元用于办公室就诊，529美元用于住院，176美元用于医院门诊就诊，105美元用于急诊室就诊。对于某些群体，哮喘的人均递增医疗费用与人口平均水平不同，即未投保者为2 145美元，生活在贫困线以下者为3 581美元。在2008-2013年期间，哮喘造成了30亿美元的损失，其中包括因错过工作和上学时间而造成的损失，290亿美元的哮喘相关死亡率以及503亿美元的医疗费用。根据汇总样本，2013年美国哮喘的总费用为819亿美元。结论：哮喘给美国带来了巨大的经济负担，2013年哮喘的总费用（包括缺勤和死亡造成的费用）为819亿美元。
Rationale: Asthma is a chronic disease that affects quality of life, productivity at work and school, and healthcare use; and it can result in death. Measuring the current economic burden of asthma provides important information on the impact of asthma on society. This information can be used to make informed decisions about allocation of limited public health resources.Objectives: In this paper, we provide a comprehensive approach to estimating the current prevalence, medical costs, cost of absenteeism (missed work and school days), and mortality attributable to asthma from a national perspective. In addition, we estimate the association of the incremental medical cost of asthma with several important factors, including race/ethnicity, education, poverty, and insurance status.Methods: The primary source of data was the 2008-2013 household component of the Medical Expenditure Panel Survey. We defined treated asthma as the presence of at least one medical or pharmaceutical encounter or claim associated with asthma. For the main analysis, we applied two-part regression models to estimate asthma-related annual per-person incremental medical costs and negative binomial models to estimate absenteeism associated with asthma.Results: Of 213,994 people in the pooled sample, 10,237 persons had treated asthma (prevalence, 4.8%). The annual per-person incremental medical cost of asthma was $3,266 (in 2015 U.S. dollars), of which $1,830 was attributable to prescription medication, $640 to office visits, $529 to hospitalizations, $176 to hospital-based outpatient visits, and $105 to emergency room visits. For certain groups, the per-person incremental medical cost of asthma differed from that of the population average, namely $2,145 for uninsured persons and $3,581 for those living below the poverty line. During 2008-2013, asthma was responsible for $3 billion in losses due to missed work and school days, $29 billion due to asthma-related mortality, and $50.3 billion in medical costs. All combined, the total cost of asthma in the United States based on the pooled sample amounted to $81.9 billion in 2013.Conclusions: Asthma places a significant economic burden on the United States, with a total cost of asthma, including costs incurred by absenteeism and mortality, of $81.9 billion in 2013.