An economic assessment of pediatric asthma in the Louisiana Medicaid population.

摘要

The purpose of this study was to describe and analyze by demographic and health status variables and by different treatment methods the asthma-related health care resource utilization and expenditures incurred for pediatric asthma patients by the Louisiana Medicaid Program. A retrospective longitudinal analysis used claims data of Louisiana Medicaid pediatric asthma patients from 1996 to 1998. The majority of patients was black, male, 1 to 11 years of age, and resided in urban areas. Asthma hospitalizations and emergency department visits accounted for over 50% of all asthma-related expenditures, followed by asthma prescriptions (≈30%). Relievers accounted for half of all asthma prescription expenditures. Mean annual asthma-related expenditures amounted to {dollar}632.55 (1996), {dollar}520.28 (1997), and {dollar}550.71 (1998).; A large proportion of patients acquired drug therapy at inappropriate levels. Most filled an average of 4 relievers per year, many of which were used as monotherapy. As a result, many were hospitalized and/or admitted to the emergency department.; More patients 1 to 4 years of age and racial minorities were hospitalized and admitted to the emergency department. Less than 8% of high utilizers accounted for over half of all asthma-related expenditures. Age, race, and residence and their interactions appeared to be significant factors explaining some of the variance in the number of long-term-controllers filled.; The introduction of inhaled corticosteroids and cromolyn sodium and nedocromil as long-term acting drug therapies may have influenced significant reductions in asthma-related expenditures for hospital visits. In addition, visits to emergency rooms for asthma-related services may also have been reduced. Of course, prescription drug expenditures for asthma were also higher.; A large proportion of the asthma-related expenditures incurred for the years 1996 to 1998 may have been due to uncontrolled disease. The findings of this study suggest that health care professionals can play an important role in providing disease management and education skills to reduce the use of inappropriate, unnecessary, and often costly asthma-related health services. This could provide savings in public expenditures without compromising the quality of asthma care.