The economic burden of asthma in US children: Estimates from the National Medical Expenditure Survey

Background: Asthma is the leading chronic illness of childhood, is responsi ble for substantial pediatric morbidity, and has a significant impact on us e of health resources. Objective: Our purpose was to assess the per capita impact of pediatric ast hma on medical care utilization and total expenditures, Methods: A population-based national probability survey, the National Medic al Expenditure Survey, was conducted in 1987 to determine the use and cost of health care services in the United States. Ne analyzed the responses for all children aged 1 to 17 pars with (n = 667) and without (n = 6911) asthm a. Children with asthma were identified with use of a population-based scre ening question. Frequency and cost of medications, ambulatory visits, emerg ency department care, and hospitalizations for all reasons, including asthm a, were assessed. Results: The period prevalence of childhood asthma in 1987 was 8.8% and the treated prevalence (any asthma medications) was 4.0%. Forty-one percent of families with asthmatic children were classified as having no primary insu rance. Children with asthma used substantially more services in all categor ies of care: 3.1 times as many prescriptions, 1.9 times as many ambulatory provider visits, 2.2 times as many emergency department visits, and 3.5 tim es as many hospitalizations. Only 10.7% of children with asthma were define d as chronic users of medications. Children with asthma incurred an average of $1129 (SD $5310) per child per year in total health care expenditures c ompared with $468 (SD $2960) for children without asthma, a 2.8-fold differ ence. Conclusion: Asthma has considerable impact on the use and costs of medical care services among US children. Data from the 1987 National Medical Expend iture Survey provide a useful baseline against which more recent, postguide line data should be compared.