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. 2010 Mar-Apr;17(2):74-80.
doi: 10.1155/2010/361071.

Direct health care costs associated with asthma in British Columbia

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Direct health care costs associated with asthma in British Columbia

Mohsen Sadatsafavi et al. Can Respir J. 2010 Mar-Apr.

Abstract

Background: A better understanding of health care costs associated with asthma would enable the estimation of the economic burden of this increasingly common disease.

Objective: To determine the direct medical costs of asthma-related health care in British Columbia (BC).

Methods: Administrative health care data from the BC Linked Health Database and PharmaNet database from 1996 to 2000 were analyzed for BC residents five to 55 years of age, including the billing information for physician visits, drug dispensations and hospital discharge records. A unit cost was assigned to physician/emergency department visits, and government reimbursement fees for prescribed medications were applied. The case mix method was used to calculate hospitalization costs. All costs were reported in inflation-adjusted 2006 Canadian dollars.

Results: Asthma resulted in $41,858,610 in annual health care-related costs during the study period ($331 per patient-year). The major cost component was medications, which accounted for 63.9% of total costs, followed by physician visits (18.3%) and hospitalization (17.8%). When broader definitions of asthma-related hospitalizations and physician visits were used, total costs increased to $56,114,574 annually ($444 per patient-year). There was a statistically significant decrease in the annual per patient cost of hospitalizations (P<0.01) over the study period. Asthma was poorly controlled in 63.5% of patients, with this group being responsible for 94% of asthma-related resource use.

Conclusion: The economic burden of asthma is significant in BC, with the majority of the cost attributed to poor asthma control. Policy makers should investigate the reason for lack of proper asthma control and adjust their policies accordingly to improve asthma management.

HISTORIQUE :: Si on comprenait mieux les coûts liés aux soins de santé associés à l’asthme, on pourrait évaluer le fardeau économique de cette maladie de plus en plus courante.

OBJECTIF :: Déterminer les coûts médicaux directs des soins de santé liés à l’asthme en Colombie-Britannique (C.-B).

MÉTHODOLOGIE :: Les auteurs ont analysé les données administratives liées aux soins de santé tirées de la Linked Health Database de la C.-B. et de la base de données PharmaNet entre 1996 et 2000 à l’égard des habitants de cinq à 55 ans, y compris les renseignements sur la facturation des visites des médecins, la dispensation de médicaments et les dossiers de congé de l’hôpital. Ils ont attribué un coût unitaire aux visites aux médecins et à l’urgence et appliqué un coût de remboursement gouvernemental aux médicaments prescrits. Ils ont utilisé la méthode de la charge de cas pour calculer les frais d’hospitalisation. Tous ces coûts étaient déclarés en dollars canadiens de 2006 rajustés en fonction de l’inflation.

RÉSULTATS :: L’asthme entraîne des coûts annuels liés aux soins de santé de 41 858 610 $ pendant la période de l’étude (331 $ par patient-année). Le principal élément de coût provenait des médicaments, qui représentaient 63,9 % des coûts totaux, suivi des visites aux médecins (18,3 %) et des hospitalisations (17,8 %). Lorsqu’on utilisait les grandes définitions des hospitalisations et des visites aux médecins liées à l’asthme, les coûts annuels totaux passaient à 56 114 574 $ (444 $ par patient-année). On constatait une diminution statistiquement significative du coût annuel des hospitalisations par patient (P<0,01) au cours de la période de l’étude. L’asthme était mal contrôlé chez 63,5 % des patients, ce groupe étant responsable de 94 % de l’utilisation des ressources liées à l’asthme.

CONCLUSION :: Le fardeau économique de l’asthme est important en C.-B., la majorité des coûts étant attribuables à un mauvais contrôle de l’asthme. Les décideurs devraient explorer la raison de ce manque de contrôle convenable de l’asthme et rajuster leurs politiques en conséquence, afin d’en améliorer la prise en charge.

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Figures

Figure 1)
Figure 1)
Annual total cost of asthma (left panel) and per-patient cost (right panel) in British Columbia according to year and cost component (inflation-adjusted 2006 Canadian dollars). The number of subjects for each year of data was as follows: 1996: 109,236; 1997: 131,119; 1998: 137,593; 1999: 135,780; 2000: 118,291. ED Emergency department
Figure 2)
Figure 2)
Share (%) of the total direct cost of asthma for different levels of severity and control
Figure 3)
Figure 3)
Breakdown of annual per-patient costs per level of asthma severity (left panel) and control (right panel)

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