A NATIONAL ESTIMATE OF THE ECONOMIC COSTS OF ASTHMA

This cost of illness analysis examines national cost and resource util ization by persons with asthma using a single, comprehensive data sour ce, the 1987 National Medical Expenditure Survey. Direct medical expen ditures included payments for ambulatory care visits, hospital outpati ent services, hospital inpatient stays, emergency department visits, p hysician and facility payments, and prescribed medicines. Indirect med ical costs included costs resulting from missed work or school and day s with restricted activity at work. Point estimates and 95% confidence intervals (CI) were calculated and inflated to 1994 dollars. The tota l estimated cost was $5.8 billion (95% CI, $3.6 to $8 billion). The es timated direct expenditures were $5.1 billion (95% CI, $3.3 to $7.0 bi llion), and indirect expenditures were valued at $673 million (95% CI, $271 to $1,076 million). Hospitalization accounted for more than half of all expenditures. More than 80% of resources were used by 20% of t he population (defined as 'high-cost patients'). The estimated annual per patient cost for those high-cost patients was $2,584, in contrast with $140 for the rest of the sample. Findings from this study indicat e that future asthma research and intervention efforts directed at hos pitalizations and high-cost patients could help to decrease health car e resource use and provide cost savings.