按居住地分列的美国儿童哮喘控制，治疗，医疗保健利用和支出趋势：2003-2014
2019/03/21
摘要
背景：研究哮喘治疗和控制的国家趋势对于治疗和公共卫生计划的实施至关重要。本文旨在探讨儿童和居住在贫困城市地区的儿童哮喘控制和治疗的国家趋势。
方法：这是一项来自2003 - 2014年医疗支出小组调查（MEPS）中1-17岁儿童趋势的分析。控制不佳的指标包括3个月内使用大于3罐短效β受体激动剂（SABA），哮喘发作，急诊（ED）就诊/住院（IP）治疗和使用全身性皮质类固醇（SCS）。治疗指标包括吸入皮质类固醇（ICS），控制药物，SABA和控制药物比例≥0.7。其他指标包括哮喘药物的数量，门诊就诊，哮喘特异性药物使用和每位患者每年的总支出。
结果：2014年美国有840万哮喘儿童，11.1％生活在贫困城市地区。ICS使用，控制药物，每日预防药物，SCS，SABA，> 3罐SABA（3个月），整体哮喘药物和门诊就诊的儿童百分比显著下降，哮喘发作的儿童比例显著增加，其结果有统计学差异。将居住在贫困城市地区的儿童的趋势与所有其他儿童的趋势进行比较，然而，数据有限和年度估计数的变化导致不能得到明确的结论。
结论：结果表明，自2003年以来美国哮喘患儿的治疗和控制缺乏改善。儿童的哮喘控制和疾病管理有很大的改善空间。
Trends in Asthma Control, Treatment, Healthcare Utilization and Expenditures among Children in the United States by Place of Residence: 2003-2014.
Sullivan PW, Vahram G, Abhishek K, Prakash N, Friedman HS, Benjamin O.
Abstract
BACKGROUND:Examining national trends in asthma treatment and control is essential to inform treatment and public health initiatives. Explore national trends in asthma control and treatment over time among children and those residing in poor-urban areas.
METHODS:This was an analysis of trends from 2003-2014 among children (aged 1-17) in the Medical Expenditure Panel Survey (MEPS). Indicators of poor control included use of >3 canisters short-acting beta agonist (SABA) in 3 months, asthma attack, Emergency Department (ED)/inpatient (IP) hospitalization and systemic corticosteroids (SCS). Treatment included inhaled corticosteroids (ICS), controller medications, SABA and ratio of controller-to-total prescriptions ≥ 0.7. Other measures included the number of asthma medications, outpatient visits, asthma-specific drug and total expenditures per-patient-per-year.
RESULTS:There were 8.4 million children with asthma in the U.S. in 2014; 11.1% lived in poor-urban areas. There was a statistically significant decrease in the percentage of children using ICS, controller medications, daily preventive medications, SCS, SABA, > 3 canisters SABA (in 3 months), overall asthma prescriptions and outpatient visits. There was a significant increase in the percentage of children reporting having an asthma attack. Trends for children residing in poor-urban areas were compared to all others, however, limited data and variability in annual estimates prevent clear conclusions.
CONCLUSIONS:Results suggest lack of improvement in treatment and control since 2003 among children with asthma in the U.S. There is significant room for improvement in asthma control and disease management among children.
背景：研究哮喘治疗和控制的国家趋势对于治疗和公共卫生计划的实施至关重要。本文旨在探讨儿童和居住在贫困城市地区的儿童哮喘控制和治疗的国家趋势。
方法：这是一项来自2003 - 2014年医疗支出小组调查（MEPS）中1-17岁儿童趋势的分析。控制不佳的指标包括3个月内使用大于3罐短效β受体激动剂（SABA），哮喘发作，急诊（ED）就诊/住院（IP）治疗和使用全身性皮质类固醇（SCS）。治疗指标包括吸入皮质类固醇（ICS），控制药物，SABA和控制药物比例≥0.7。其他指标包括哮喘药物的数量，门诊就诊，哮喘特异性药物使用和每位患者每年的总支出。
结果：2014年美国有840万哮喘儿童，11.1％生活在贫困城市地区。ICS使用，控制药物，每日预防药物，SCS，SABA，> 3罐SABA（3个月），整体哮喘药物和门诊就诊的儿童百分比显著下降，哮喘发作的儿童比例显著增加，其结果有统计学差异。将居住在贫困城市地区的儿童的趋势与所有其他儿童的趋势进行比较，然而，数据有限和年度估计数的变化导致不能得到明确的结论。
结论：结果表明，自2003年以来美国哮喘患儿的治疗和控制缺乏改善。儿童的哮喘控制和疾病管理有很大的改善空间。
(中日友好医院呼吸与危重症医学科 王瑞茵 摘译 林江涛 审校)
(J Allergy Clin Immunol Pract. 2019 Feb 14. pii: S2213-2198(19)30164-3. doi: 10.1016/j.jaip.2019.01.055. [Epub ahead of print])
(J Allergy Clin Immunol Pract. 2019 Feb 14. pii: S2213-2198(19)30164-3. doi: 10.1016/j.jaip.2019.01.055. [Epub ahead of print])
Trends in Asthma Control, Treatment, Healthcare Utilization and Expenditures among Children in the United States by Place of Residence: 2003-2014.
Sullivan PW, Vahram G, Abhishek K, Prakash N, Friedman HS, Benjamin O.
Abstract
BACKGROUND:Examining national trends in asthma treatment and control is essential to inform treatment and public health initiatives. Explore national trends in asthma control and treatment over time among children and those residing in poor-urban areas.
METHODS:This was an analysis of trends from 2003-2014 among children (aged 1-17) in the Medical Expenditure Panel Survey (MEPS). Indicators of poor control included use of >3 canisters short-acting beta agonist (SABA) in 3 months, asthma attack, Emergency Department (ED)/inpatient (IP) hospitalization and systemic corticosteroids (SCS). Treatment included inhaled corticosteroids (ICS), controller medications, SABA and ratio of controller-to-total prescriptions ≥ 0.7. Other measures included the number of asthma medications, outpatient visits, asthma-specific drug and total expenditures per-patient-per-year.
RESULTS:There were 8.4 million children with asthma in the U.S. in 2014; 11.1% lived in poor-urban areas. There was a statistically significant decrease in the percentage of children using ICS, controller medications, daily preventive medications, SCS, SABA, > 3 canisters SABA (in 3 months), overall asthma prescriptions and outpatient visits. There was a significant increase in the percentage of children reporting having an asthma attack. Trends for children residing in poor-urban areas were compared to all others, however, limited data and variability in annual estimates prevent clear conclusions.
CONCLUSIONS:Results suggest lack of improvement in treatment and control since 2003 among children with asthma in the U.S. There is significant room for improvement in asthma control and disease management among children.
上一篇：
2000年和2010年美国邻近地区交通相关的空气污染和儿童哮喘负担
下一篇：
英国当前哮喘患病率和吸入性皮质类固醇治疗的变化：基于人群2006-2016的队列
