Trends in cost and outcomes among adult and pediatric patients with asthma: 2000-2009

Abstract

Background: Few studies have examined recent trends in medical expenditures and outcomes in patients with asthma.

Objective: To examine the level and changes in medical expenditures, health status, and functional outcomes in adults, adolescents, and children with asthma and to provide nationally representative estimates of asthma medical costs from 2000 through 2009.

Methods: Medical Expenditure Panel Surveys from 2000 through 2009 were used to estimate the trends of medical expenditures (adjusted for medical price inflation), number of workdays lost or schooldays lost, and/or the physical component summary and the mental component summary from the revised 12-Item Short-Form Health Survey, adjusting for sociodemographic variables and comorbidities.

Results: The averaged physical component summary decreased 0.09 units annually (95% confidence interval 0.02-0.16, P < .01) in adults, but there were no significant changes to the averaged mental component summary. There was no significant change in the number of workdays lost and a marginal decrease of 1.8% per annum in the number of schooldays lost (95% confidence interval -0.1 to 3.5, P = .06). The medical expenditure means increased 2.5% annually in adolescents (95% confidence interval 0.0-4.9, P = .049), but there were no significant changes for adults and children. The total incremental medical expenditures of asthma in the United States were estimated to be $62.8 billion in 2009.

Conclusion: This study found that, although medical costs for patients with asthma increased or remained stable across all age groups over a 10-year period, outcomes did not improve. Considering the economic burden of asthma and the previous 10-year performance, continued attention should be focused on asthma management in the United States.