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Am. J. Respir. Crit. Care Med., Volume 156, Number 3, September 1997, 787-793

A National Estimate of the Economic Costs of Asthma

DAVID H. SMITH, DANIEL C. MALONE, KENNETH A. LAWSON, LYNN J. OKAMOTO, CARMELINA BATTISTA, and WILLIAM B. SAUNDERS

Departments of Pharmacy and Health Services, University of Washington, Seattle, Washington; Department of Pharmacy Practice, University of Colorado, Denver, Colorado; and Pharmacy Practice and Administration Division, The University of Texas at Austin, Austin, Texas; and Glaxo Wellcome Inc., Research Triangle Park, North Carolina

This cost of illness analysis examines national cost and resource utilization by persons with asthma using a single, comprehensive data source, the 1987 National Medical Expenditure Survey. Direct medical expenditures included payments for ambulatory care visits, hospital outpatient services, hospital inpatient stays, emergency department visits, physician and facility payments, and prescribed medicines. Indirect medical costs included costs resulting from missed work or school and days with restricted activity at work. Point estimates and 95% confidence intervals (CI) were calculated and inflated to 1994 dollars. The total estimated cost was $5.8 billion (95% CI, $3.6 to $8 billion). The estimated direct expenditures were $5.1 billion (95% CI, $3.3 to $7.0 billion), and indirect expenditures were valued at $673 million (95% CI, $271 to $1,076 million). Hospitalization accounted for more than half of all expenditures. More than 80% of resources were used by 20% of the population (defined as `high-cost patients'). The estimated annual per patient cost for those high-cost patients was $2,584, in contrast with $140 for the rest of the sample. Findings from this study indicate that future asthma research and intervention efforts directed at hospitalizations and high-cost patients could help to decrease health care resource use and provide cost savings.




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