PURPOSE: Allergic rhinitis (AR) is common among children with asthma and exacerbates asthma symptoms. To assess the incremental utilization and cost of asthma-related health services due to concomitant AR among asthmatic children. MATERIALS and METHODS: Asthma-related claims were extracted from the Korean National Health Insurance (NHI) claims database, which covers 97% of the population. Per-capita utilization and costs of asthma-related services were determined from the societal perspective. RESULTS: Of 319,714 children (1-14 years old) with chronic asthma in 2003, 195,026 had concomitant AR (prevalence 610 per 1,000 asthmatic children). Children with AR had 1.14 times more outpatient visits, 1.30 times more emergency department (ED) visits, and 1.49 times more hospitalizations than children without AR. More children with AR used general hospitals (7.17%) than children without AR (3.23%). The ratios of unit pharmaceutical costs per outpatient visit, ED visit, and admission between children with and without AR were 1.27, 1.20, and 1.14. Total annual expenditure combining direct health care, transportation, and caregivers' costs, were dollar 273 and dollar 217 for children with and without AR, respectively. CONCLUSION: Health service utilization and costs for asthma were greater for asthmatic children with AR. More frequent ED visits and admissions among asthmatic children with AR suggest poorer control and more frequent exacerbations. Higher unit cost of pharmaceuticals during visits, tendency to receive asthma care from a higher-level facility, and greater risk of ED visit or admission all contributed to the additional economic burden of AR.
Adolescent ; Asthma/*economics/*epidemiology ; Child ; Child, Preschool ; Female ; Health Services/economics/statistics & numerical data ; Humans ; Hypersensitivity/economics/epidemiology ; Infant ; Male ; Rhinitis/*economics/*epidemiology

PURPOSE: To estimate annual health care and productivity loss costs attributable to overweight or obesity in working asthmatic patients. MATERIALS AND METHODS: This study was conducted using the 2003–2013 Medical Expenditure Panel Survey (MEPS) in the United States. Patients aged 18 to 64 years with asthma were identified via self-reported diagnosis, a Clinical Classification Code of 128, or a ICD-9-CM code of 493.xx. All-cause health care costs were estimated using a generalized linear model with a log function and a gamma distribution. Productivity loss costs were estimated in relation to hourly wages and missed work days, and a two-part model was used to adjust for patients with zero costs. To estimate the costs attributable to overweight or obesity in asthma patients, costs were estimated by the recycled prediction method. RESULTS: Among 11670 working patients with a diagnosis of asthma, 4428 (35.2%) were obese and 3761 (33.0%) were overweight. The health care costs attributable to obesity and overweight in working asthma patients were estimated to be $878 [95% confidence interval (CI): $861–$895] and $257 (95% CI: $251–$262) per person per year, respectively, from 2003 to 2013. The productivity loss costs attributable to obesity and overweight among working asthma patients were $256 (95% CI: $253–$260) and $26 (95% CI: $26–$27) per person per year, respectively. CONCLUSION: Health care and productivity loss costs attributable to overweight and obesity in asthma patients are substantial. This study's results highlight the importance of effective public health and educational initiatives targeted at reducing overweight and obesity among patients with asthma, which may help lower the economic burden of asthma.
Adult ; Asthma/*economics/epidemiology/therapy ; *Cost of Illness ; *Efficiency ; *Employment ; Female ; *Health Care Costs ; Health Expenditures ; Humans ; Male ; Middle Aged ; Obesity/*economics/epidemiology/therapy ; Overweight/economics/epidemiology/therapy ; United States/epidemiology ; Young Adult

A systematic review of English and Korean articles published between 1990 and 2004 and a search of database and various online resources was conducted to determine the prevalences, mortality rates, socioeconomic burden, quality of life, and treatment pattern of asthma in Korean adults and children. Asthma morbidity and mortality in Korea are steadily increasing. The prevalence of asthma in Korea is estimated to be 3.9% and its severity is often underestimated by both physicians and patients. Mortality resulting from chronic lower respiratory diseases including asthma increased from 12.9 to 22.6 deaths per 100,000 of the population between 1992 and 2002. Disease severity, level of control, and symptom state were all found to negatively impact the quality of life of asthmatics. Although international and Korean asthma management guidelines are available, familiarity with and implementation of these guidelines by primary care physicians remain poor.
Risk Factors ; Quality of Life ; Practice Guidelines ; Korea/epidemiology ; Humans ; Costs and Cost Analysis ; Child ; *Asthma/economics/epidemiology/mortality/therapy ; Adult

OBJECTIVETo understand childhood asthma from age 0 to 14 in Kaifeng city and the relevant risk factors, effects of therapy and costs.

METHODSEleven thousand children aged 0 to 14 were chosen in Gulou area, Shunhe area using cluster sampling.

RESULTS(1) The overall prevalence of childhood asthma was 1.16% sex ratio 1.72:1. Significant difference was found among every age group (P < 0.001), with the highest from 0 to 3, the prevalence rate in industrial area was significantly higher than that of residential area, with a ratio of 2.13:1 (P < 0.001). (2) Major relevant factors were found to be: history of hypersensitivity, upper respiratory infection and family history; while nationalities, history of contact with pets were not found to be related to childhood asthma (P > 0.05). (3) The expenditure was significantly different between non-specific therapy and specified therapy (P < 0.001). Among those children with asthma, 89.8% did not get specified treatment and the average expenditure was 2,375.2 Yuan per year, which was 10.2% of accepted specified therapy, namely under GINA program, with average expenditure 653.68 Yuan every year.

CONCLUSIONThe result of this study provided scientific basis for child asthma prevention and cure in this area.

Adolescent ; Asthma ; economics ; epidemiology ; etiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Prevalence