哮喘联盟

   摘要
   目的：哮喘作为一种严重的慢性肺部疾病影响着大约2千6百万的美国人，给医疗保健系统带来临床和经济负担。虽然已知哮喘未控制与不良健康预后相关，但在美国哮喘未控制对经济结果的影响程度尚未知。本研究旨在明确在美国哮喘、哮喘控制以及经济结果间的关系。
   方法：通过2008～2010年医疗费用小组调查评估哮喘未控制(哮喘相关急诊室就诊、过去3个月内使用>3罐的快速缓解吸入剂或过去12个月内的哮喘发作)对医疗支出、医疗资源使用和生产力的影响。调整社会人口统计数据和并发症后，采用多元回归进行评估。
   结果：与无哮喘者相比，哮喘未控制患者由于哮喘而产生的医疗支出更高，高达$4423；且哮喘未控制患者出院频率更高，为无哮喘者的4.6倍(p < 0.01)，其他哮喘患者并没有明显更高的出院率。哮喘未控制患者的急诊室就诊次数是无哮喘者的1.8倍(p < 0.01)。哮喘未控制患者的生产力显著降低(p < 0.01)(更可能失业，更多的旷工天数和更多的活动受限)。
   结论：最新的全国数据显示，哮喘以及哮喘未控制患者具有更高的医疗支出、更多的医疗资源使用和生产力下降。
 

（苏楠 审校）
J Asthma. 2014 Apr 7. [Epub ahead of print]

 

The relationship between asthma, asthma control and economic outcomes in the United States.
 

Sullivan PW1, Slejko JF, Ghushchyan VH, Sucher B, Globe DR, Lin SL, Globe G.
 

ABSTRACT
OBJECTIVE: Asthma, a serious chronic lung disease affecting approximately 26 million Americans, remains clinical and economic burdens on the healthcare system. Although associations between uncontrolled asthma and poor health outcomes is known, the extent of this impact of uncontrolled asthma on economic outcomes in the United States (US) is unknown. We sought to determine the relationship between asthma, asthma control and economic outcomes in the US.
METHODS: The 2008-2010 Medical Expenditure Panel Surveys were used to estimate the impact of uncontrolled asthma (asthma-related emergency department [ED] visit, use of >3 canisters of quick-relief inhaler in past 3 months or asthma attack in past 12 months) on medical expenditures, utilization and productivity. Estimates were generated using multivariate regression controlling for sociodemographics and comorbidity.
RESULTS: Medical expenditures attributable to asthma were up to $4423 greater for those with markers of uncontrolled asthma compared with those who did not have asthma. Frequency of hospital discharges were up to 4.6-fold greater for those with uncontrolled asthma than those without asthma (p < 0.01), while all others with asthma did not have significantly more discharges. ED visits were up to 1.8-fold greater for those with uncontrolled asthma compared with those without asthma (p < 0.01). Productivity was significantly (p < 0.01) decreased (more likely to be unemployed, more days absent from work and more activity limitations) for those with uncontrolled asthma.
CONCLUSIONS:In recent national data, individuals with asthma and markers of uncontrolled asthma had higher medical expenditures, greater utilization and decreased productivity.
 

J Asthma. 2014 Apr 7. [Epub ahead of print]