An Economic Evaluation of Asthma in the United States

Weiss, Kevin B.; Gergen, Peter J.; Hodgson, Thomas A.

doi:10.1056/nejm199203263261304

Cited by 904 publications

(374 citation statements)

References 11 publications

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“…To examine the costs of childhood asthma, we considered the economic impacts that have been shown in previous studies to be associated with emergency room use, hospitalization, and death from the disease (18)(19)(20)(21)(22)(23)(53)(54)(55). Those earlier studies used data from various sources including the annual National Hospital Discharge Survey, the 1985 National Ambulatory Medical Care Survey, the annual National Health Interview Survey, the 1980 National Medical Care Utilization and Expenditure Survey, the 1987 National Medical Expenditure Survey, and a managed health care database of medical and pharmacy claims (56).…”

Section: Disease-specific Methodologiesmentioning

confidence: 99%

“…Previous studies have examined the incidence and prevalence of lead poisoning (15,16) and of pediatric asthma (3,4) and have calculated the costs associated with these conditions (17)(18)(19)(20)(21)(22)(23)(24)(25). The costs of learning disabilities and developmental disorders have also been estimated (26), and a committee convened by the U.S. National Academy of Sciences has estimated the fraction of neurobehavioral disorders that may be attributable to environmental factors (27).…”

mentioning

confidence: 99%

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Environmental pollutants and disease in American children: estimates of morbidity, mortality, and costs for lead poisoning, asthma, cancer, and developmental disabilities.

Landrigan

Schechter

Lipton

et al. 2002

Environ Health Perspect

451

283

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In this study, we aimed to estimate the contribution of environmental pollutants to the incidence, prevalence, mortality, and costs of pediatric disease in American children. We examined four categories of illness: lead poisoning, asthma, cancer, and neurobehavioral disorders. To estimate the proportion of each attributable to toxins in the environment, we used an environmentally attributable fraction (EAF) model. EAFs for lead poisoning, asthma, and cancer were developed by panels of experts through a Delphi process, whereas that for neurobehavioral disorders was based on data from the National Academy of Sciences. We define environmental pollutants as toxic chemicals of human origin in air, food, water, and communities. To develop estimates of costs, we relied on data from the U.S. Environmental Protection Agency, Centers for Disease Control and Prevention, National Center for Health Statistics, the Bureau of Labor Statistics, the Health Care Financing Agency, and the Practice Management Information Corporation. EAFs were judged to be 100% for lead poisoning, 30% for asthma (range, 10-35%), 5% for cancer (range, 2-10%), and 10% for neurobehavioral disorders (range, 5-20%). Total annual costs are estimated to be $54.9 billion (range $48.8-64.8 billion): $43.4 billion for lead poisoning, $2.0 billion for asthma, $0.3 billion for childhood cancer, and $9.2 billion for neurobehavioral disorders. This sum amounts to 2.8 percent of total U.S. health care costs. This estimate is likely low because it considers only four categories of illness, incorporates conservative assumptions, ignores costs of pain and suffering, and does not include late complications for which etiologic associations are poorly quantified. The costs of pediatric environmental disease are high, in contrast with the limited resources directed to research, tracking, and prevention.

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Section: Disease-specific Methodologiesmentioning

confidence: 99%

mentioning

confidence: 99%

Environmental pollutants and disease in American children: estimates of morbidity, mortality, and costs for lead poisoning, asthma, cancer, and developmental disabilities.

Landrigan

Schechter

Lipton

et al. 2002

Environ Health Perspect

451

283

View full text Add to dashboard Cite

show abstract

“…Indirect costs include costs resulting from missed work or school days and days with restricted activity at work, premature retirement and death. The adverse impact of asthma on the quality of life of the patients and on the families, as well as the limitation of physical, emotional and intellectual development is difficult to quantify, and therefore is referred to as intangible costs (8)(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Direct costs of asthma in Brazil: a comparison between controlled and uncontrolled asthmatic patients

Santos

Oliveira

Faresin

et al. 2007

Braz J Med Biol Res

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Asthma is a common chronic illness that imposes a heavy burden on all aspects of the patient's life, including personal and health care cost expenditures. To analyze the direct cost associated to uncontrolled asthma patients, a cross-sectional study was conducted to determine costs related to patients with uncontrolled and controlled asthma. Uncontrolled patient was defined by daytime symptoms more than twice a week or nocturnal symptoms during two consecutive nights or any limitations of activities, or need for relief rescue medication more than twice a week, and an ACQ score less than 2 points. A questionnaire about direct cost stratification in health services, including emergency room visits, hospitalization, ambulatory visits, and asthma medications prescribed, was applied. Ninety asthma patients were enrolled (45 uncontrolled/45 controlled).

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“…1 The diagnosis of asthma is difficult in infants and toddlers given their age and the frequency of isolated wheezing for other reasons (e.g., respiratory infections). Nevertheless, evidence suggests that half of all cases of childhood asthma are diagnosed by age 3 years, and 80% of all childhood asthma cases are diagnosed by 5.…”

Section: Introductionmentioning

confidence: 99%

Association of birth weight with asthma‐related outcomes at age 2 years

Taveras

Camargo

Rifas‐Shiman

et al. 2006

Pediatric Pulmonology

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Summary. Background: Although lower birth weight associated with prematurity raises the risk of asthma in childhood, few prospective studies have examined higher birth weight, and few have separated the two components of birth weight, fetal growth and length of gestation.Objective. To examine the associations of fetal growth and length of gestation with asthma-related outcomes by age 2 years. Methods.We studied 1,372 infants and toddlers born after 34 weeks' gestation in Project Viva, a prospective cohort study of pregnant mothers and their children. The main outcome measures were parent report of (1) any wheezing (or whistling in the chest) from birth to age 2 years, (2) recurrent wheezing during the first 2 years of life, and (3) doctor's diagnosis of asthma, wheeze or reactive airwaydisease ("asthma") by age 2. We calculated gestational age from the last menstrual period or ultrasound examination, and determined birth weight for gestational age z-value ("fetal growth") using US national reference data.Results. Infants' mean birth weight was 3,527 (SD, 517; range, 1,559-5,528) grams. By age 2 years, 34% of children had any wheezing, 14% had recurrent wheezing, and 16% had doctor-diagnosed asthma. After adjusting for several parent, child, and household characteristics in logistic regression models, we found that infants with birth weight ≥4,000 g were not more likely to have any wheezing (odds ratio (OR), 0.91; 95% confidence interval (CI): 0.62, 1.34) or doctor-diagnosed asthma (OR, 0.80; 95% CI: 0.49, 1.31) than infants with birth weight 3,500-3,999 g. In models examining length of gestation and fetal growth separately, neither the highest nor the lowest groups of either predictor were associated with the three outcomes. Boys had a higher incidence of asthma-related outcomes than girls, and exposure to passive smoking, parental history of asthma, and exposure to older siblings were all associated with greater risk of recurrent wheeze or asthma-related outcomes at age 2 years. Conclusion.Although male sex, exposure to smoking, parental history of asthma, and exposure to older siblingswere associated with increased riskof wheezing and asthma-related outcomes in this prospective study of children born after 34 weeks gestation, fetal growth and length of gestation were not.

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An Economic Evaluation of Asthma in the United States

Cited by 904 publications

References 11 publications

Environmental pollutants and disease in American children: estimates of morbidity, mortality, and costs for lead poisoning, asthma, cancer, and developmental disabilities.

Environmental pollutants and disease in American children: estimates of morbidity, mortality, and costs for lead poisoning, asthma, cancer, and developmental disabilities.

Direct costs of asthma in Brazil: a comparison between controlled and uncontrolled asthmatic patients

Association of birth weight with asthma‐related outcomes at age 2 years

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