Saving in medical costs by achieving guideline-based asthma symptom control: a population-based study
| Autor: | Wenjia Chen, JM FitzGerald, J. D. Rolf, Roxanne Rousseau, Hamid Tavakoli, Mohsen Sadatsafavi |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Cost effectiveness Immunology Population 03 medical and health sciences Indirect costs 0302 clinical medicine Ambulatory care Risk Factors immune system diseases Outcome Assessment Health Care medicine Humans Immunology and Allergy 030212 general & internal medicine Disease management (health) education Aged Asthma education.field_of_study British Columbia business.industry Disease Management Health Care Costs Guideline Middle Aged medicine.disease Random digit dialing respiratory tract diseases 030228 respiratory system Population Surveillance Female Guideline Adherence business |
| Zdroj: | Allergy. 71:371-377 |
| ISSN: | 0105-4538 |
| DOI: | 10.1111/all.12803 |
| Popis: | Background Asthma control is increasingly used as an outcome measure in asthma trials. Economic evaluations of asthma interventions require converting the impact of interventions on control to impact on resource use. The purpose of this study was to estimate the savings in direct costs by achieving asthma symptom control as defined in the Global Initiative for Asthma (GINA) 2014 management strategy. Methods Adolescents and adults with asthma were recruited through random digit dialing. Asthma control per GINA and the use of healthcare resources were assessed at baseline and three-monthly visits up to 1 year. We used regression models to associate costs, measured in 2012 Canadian dollars ($), with symptom control, adjusting for potential confounding variables. Results The final sample included 517 individuals (average age 48.9, 65.8% female) with mostly mild–moderate asthma contributing 2033 follow-up visits. In 598 (29.4%), 809 (39.8%), and 626 (30.8%) of visits, asthma was symptomatically controlled, partially controlled, or uncontrolled, respectively. The average 3-month costs of asthma were $134.5. Of these, 20.5% were attributable to inpatient care, 47.8% to outpatient care, and 31.5% to medication. Compared to controlled asthma, partially controlled asthma was associated with a nonsignificant increase of $9.5 (95% CI -$13.6 – $32.6) in adjusted 3-month costs and uncontrolled asthma with a statistically significant increase of $81.7 (95% CI $48.5 – $114.9). Conclusion A substantial fraction of this population-based sample of largely mild–moderate asthmatics was symptomatically uncontrolled. Achieving symptom control was associated with a reduction in direct costs. The adjusted values from this study can be used to inform cost-effectiveness analyses of asthma treatments. |
| Databáze: | OpenAIRE |
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