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

Commercial bivalent killed Salmonella vaccine Salenvac-T has been used in several countries in order to prevent salmonellosis with Salmonella enterica serovars Enteritidis (SE) and Typhimurium (ST) in poultry. However, this vaccine has not been used in poultry farms in South Korea. In this study, we evaluated the efficacy of Salenvac-T vaccine to protect against the challenge of virulent SE and ST, and the effect of the vaccine on egg production and mortality in layer hens. The colonization of liver, spleen and cecum with challenged SE and ST was reduced in vaccinated chickens compared with that of unvaccinated control group. The twice vaccination with Salenvac-T induced elevated antibody responses against both SE and ST detected by enzyme-linked immunosorbent assay (ELISA). The higher average hen-day production was observed in the vaccinated layer hens than in the unvaccinated layer hens without significance. The average mortality was lower in the vaccinated layer hens during the experiment period. The antibody responses to both SE and ST were persistently detected in the vaccinated layers. In summary, vaccination with Salenvac-T reduces colonization of internal organs and induces good antibody responses, thereby results in higher performance and lower egg contamination with SE and ST in layer hens.
Antibody Formation ; Cecum ; Chickens ; Colon ; Enzyme-Linked Immunosorbent Assay ; Liver ; Ovum ; Poultry ; Republic of Korea ; Salmonella ; Salmonella enterica ; Salmonella enteritidis ; Salmonella Infections ; Salmonella typhimurium ; Spleen ; Vaccination