Economic cost of adult asthmatics in the tertiary hospital of korea

Background: The prevalence of asthma is increasing and asthma cause a considerable socioeconomic burden worldwide. However, few studies were conducted to evaluate the risk factors associated with economic cost of asthma in Korea. This study was aimed to evaluate asthma cost according to severity and patients’ factors in the Korean tertiary hospital.

Methods: Direct and indirect cost was assessed in the 314 physician-diagnosed adult asthmatics randomly recruited in eight tertiary hospitals in Korea. Official direct medical cost was derived from the analysis of one-year(2009) expenditure related with asthma-related hospital care utilization and medication. Non-official direct cost(oriental medicine, instrument, and alternative medicine) and indirect cost(productivity loss cost caused by hospital care utilization, work day loss and activity limitation) were analyzed using a questionnaire designed for the study. 

Results: Mean direct and indirect cost of the total subjects was estimated at 1,690 dollars and 1,503 dollars respectively. Multivariate analysis revealed that the most important risk factor affecting economic cost was asthma severity. Direct and indirect cost were significantly higher in the severe persist asthma than in the mild to moderate persistent asthma (2,825 vs. 1,246 dollars, p=0.001, 3,734 vs. 594 dollars, p<0.001 respectively). Indirect cost and total cost were significantly higher in the female gender(p=0.020 and p=0.015 respectively) and patients with rhinitis(p=0.009 and 0.007 respectively). Asthma cost was closely correlated with asthma control status and quality of life (p<0.001).    

Conclusion: Asthma cost was significantly higher in severe persistent asthma and female gender and patients with rhinitis in Korea. Management of severe asthma is important to reduce socioeconomic burden of asthma effectively.