Correlation of financial burden with severity of asthma in children

Keya Lahiri, Fehmida Najmuddin


Introduction: Urbanisation is causing a rise in the financial burden of Asthma in children and it varies with the disease severity. Asthma has a low public health priority and is often under diagnosed and treated inappropriately. Objectives: Our aim was to correlate the financial burden of disease costs with Asthma classification. Methods: It was a prospective study of 38 patients attending paediatric pulmonology clinic in a tertiary care hospital. Details were entered in a predesigned proforma and institutional ethics committee approval was taken. Quantitative statistical analysis using mean, standard deviation and applying one way ANNOVA test was done. Results: Intermittent, mild and moderate persistent asthma were 8 (21.05%), 21(55.26%) and 9(23.68%) respectively. Majority of the patients; 19 (50%) belonged to the upper middle class. The direct mean costs across severities ranged between INR 5700-7400 for general practitioner consultation, INR 3550-10300 for emergency visits, INR 4500-9000 for investigations and INR 7000-13700 for medications. The indirect costs ranged between INR 9000-19800 on daily wages lost, INR 2900-8700 on travel expenses (significant p value<0.014) between mild and moderate persistent asthma. Mean costs on food ranged between INR 1700-3200, tuitions INR 3000-5700 and miscellaneous expenditure being INR 2000-8300. The percentage of annual income spent was 28.76%, 40.99% and 60.64% in intermittent, mild and moderate persistent asthma respectively. Conclusion: Early referral, diligent counselling, physician and parents education along with good compliance would impart effective control and thereby reduce economic burden.

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Bousquet J, Knani J, Dhivert H, Richard A, Chicoye A, Ware JE Jr, et al. Quality of life in asthma. I. Internal consistency and validity of the SF-36 questionnaire. Am J Respir Crit Care Med. 1994 Feb;149 (2 Pt 1):371-5.

Riccioni G, D'Orazio N, Di Ilio C, Menna V, Guagnano MT, Della Vecchia R. Quality of Life and clinical symptoms in asthmatic subjects. J Asthma. 2004 Feb; 41 (1): 85-9.

Gergen PJ: Understanding the economic burden of asthma. J Allergy ClinImmunol2001.107(5):5445-5448.

Braman SS. The global burden of asthma. Chest. 2006 Jul;130(1 Suppl): 4S-12S.

Vos T, Flaxman AD, Naghavi M, Lozano R et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012 Dec 15; 380 (9859): 2163-96. doi: 10.1016/ S0140-6736 (12) 61729-2.

Fowler MG, Davenport MG, Garg R. School functioning of US children with asthma. Pediatrics.1992 Dec; 90 (6): 939-44.

Grupp-Phelan J, Lozano P, Fishman P. Health care utilization and cost in children with asthma and selected comorbidities. J Asthma. 2001 Jun;38(4):363-73.

Gupta RS, Bewtra M, Prosser LA, Finkelstein JA. Predictors of hospital charges for children admitted with asthma. Ambul Pediatr. 2006 Jan-Feb; 6(1):15-20.

Agrawal S, Pearce N, Ebrahim S. Prevalence and risk factors for self-reported asthma in an adult Indian population: a cross-sectional survey. Int J Tuberc Lung Dis. 2013 Feb;17(2):275-82. doi: 10.5588/ijtld.12.0438.

Agnihotram R, and Chattopadhyay A. Respiratory Disease Burden In Rural India:A Review From Multiple Data Sources, Internet J. Epidemiol, 2005; vol 2, no.2.

Ford ES, Mannino DM, Homa DM, Gwynn C, Redd SC, Moriarty DG, et al. Self-reported asthma and health-related quality of life: findings from the behavioral risk factor surveillance system. Chest. 2003 Jan; 123(1):119-27.

Bahadori K, Doyle-Waters MM, Marra C, Lynd L, Alasaly K, Swiston J, et al. Economic burden of asthma: a systematic review. BMC Pulm Med. 2009 May 19;9:24. doi: 10.1186/1471-2466-9-24.

Sharifi L, Dashti R, Pourpak Z, Fazlollahi MR, Movahedi M, Chavoshzadeh Z, et al. Economic Burden of Pediatric Asthma: Annual Cost of Disease in Iran. Iran J Public Health. 2018 Feb;47(2):256-263.

Dashti R, Sedighy M, Pourpak Z, Ahmadiani MS, Fazlollahi MR, Bavarian B, et al. Direct economic cost of acute asthma in emergency department. Indian J Pediatr. 2013 Aug;80(8):708-9. doi: 10.1007/s12098-012 - 0912-8. Epub 2012 Nov 24.

Kauppi P, Linna M, Martikainen J, Mäkelä MJ, Haahtela T. Follow-up of the Finnish Asthma Programme 2000-2010: reduction of hospital burden needs riskgroup rethinking.Thorax. 2013Mar;68(3):292-3.doi:10.1136/thoraxjnl-2011-201028.Epub2012Apr 15.

Wang LY, Zhong Y, Wheeler L. Direct and indirect costs of asthma in school-age children. Prev Chronic Dis. 2005 Jan; 2 (1):A11. Epub 2004 Dec 15.

Cisternas MG, Blanc PD, Yen IH, Katz PP, Earnest G, Eisner MD, et al. A comprehensive study of the direct and indirect costs of adult asthma. J Allergy Clin Immunol. 2003 Jun;111(6):1212-8.

Ungar WJ, Coyte PC; Pharmacy Medication Moni-toring Program Advisory Board. Prospective study of the patient-level cost of asthma care in children. Pediatr Pulmonol. 2001 Aug; 32 (2):101-8.

Shafazand S, Colice G.Asthma: the epidemic has ended, or has it? Chest. 2004 Jun;125(6):1969-70.

Matricardi PM, Bonini S. Why is the incidence of asthma increasing? In: Johnston SL, Holgate ST(eds). Asthma: Critical Debates. London: Blackwell Science; 2002: 3-17.


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