IMPACT OF INHALED CORTICOSTEROIDS ON ASTHMA HOSPITALIZATION IN SWEDEN

This paper has two purposes. The first is to examine whether increased medication of inhaled corticosteroids by asthmatic patients is correl ated with an improvement in asthma control, measured as a reduction in asthma hospitalizations. The other purpose, if such a relationship ca n be established, is to analyse the economic consequences. Regional da ta on asthma hospitalization, i.e. number of bed-days, and sales of an ti-asthmatic drugs from 14 regions in Sweden between 1978 and 1989 wer e used (covering 71% of the Swedish population). The data were analyse d in multivariate pooled cross-section, time-series regressions. The v ariation in bed-days was explained by three variables: the sales of in haled corticosteroids; total supply of in-patient care; and sales of i nhaled bronchodilators, which were used as a proxy for asthma prevalen ce. The results indicate that sales of inhaled corticosteroids are sig nificantly correlated with decreased hospitalizations for asthma. Assu ming that the correlation also reflects a causal relationship, an incr ease in sales of inhaled corticosteroids by 1 defined daily dose (DDD) per day and 1000 inhabitants gave, on average over the study period, a reduction of 1.7 bed-days for asthma in in-patient care per 1000 inh abitants.