2009, Number 3
Health care cost and disease burden of asthmatic patients at the National Institute of Respiratory Diseases
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ABSTRACTBackground: The concept of disease burden summarizes mortality and morbidity, quantifying the impact of generated disability, and creating an indicator of healthy life expectancy.
Objective: To determine the extent of disease burden generated by asthma in hospitalized patients at the National Institute of Respiratory Diseases between June 2006 and June 2007.
Methods: Retrospective study in which 41 clinical records were randomly selected in order to obtain clinical data, factors associated to asthma exacerbations and costs. Statistical analysis was simple and bivariate. Exacerbation probability was calculated by the Kaplan-Meier procedure. Indirect financial burden included years of life lost, lived years, and disability-adjusted life years.
Results: Asthma caused 9.7% of total admissions, most of them were women of low socioeconomic status from metropolitan area and surrounding states, with a mean ± standard deviation of 1.98 ± 1.80 visits to the emergency room, and 1.12 ± 0.33 hospitalizations; 9.24 ± 5.62 days of stay, and 12 ± 6.33 disability days, there was a loss of 22.0 years of potential life and 23.49 years lived and adjusted for disability. Environmental exposures were to pollution, asbestos and industrial. Passive smoking affected 80%. Probability of positive hereditary background was 16.20-fold higher in the metropolitan area, p ‹ 0.01; half patients had another exacerbation in 4.5 months; predisposing factors were allergic rhinitis, obesity and lack of treatment adherence.
Conclusions: Asthma generated a high institutional cost, affected low-income population and was associated to controllable factors: smoking, obesity, allergic rhinitis, lack of self-care and treatment adherence.
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