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Background:
Asthma is associated
with high indirect
costs due to lower
work productivity
and higher
absenteeism and
presenteeism.
Objectives:
To study loss of
productivity
measured using the
lost workday
equivalent (LWDE)
index and health
care utilization in
asthmatics depending
on age, geographical
location, time
period, severity,
and level of asthma
control. Patients
and Methods: In this
cross-sectional,
observational,
epidemiological
multicenter study,
120 allergists
nationwide were
asked to select
asthmatic patients
aged 18 to 65 years
who were evenly
distributed
according to the 4
levels of asthma
severity (Global
Initiative on
Asthma) during 3
different seasons.
The participants
collected
sociodemographic
data, spirometry
values, Asthma
Control Test (ACT)
score, health care
utilization data,
perceived stress
according to the
Impact on Work
Productivity Index
(IMPALA, Índice del
Impacto de la
Enfermedad en la
Productividad
Laboral), and score
on the Sheehan
disability scale.
The LWDE index was
used to measure the
number of workdays
lost and the number
of workdays with
asthma symptoms
combined with the
percentage for
average performance
at work.
Results: The
study sample
comprised 1098
patients (58.7%
females; 48.5% aged
18-40 and 51.5% aged
41-65). According to
the ACT score,
disease was
uncontrolled in
57.6% of patients,
well controlled in
32.8%, and totally
controlled in 9.6%.
The mean cost due to
workdays lost was
285.81/patient/mo
(95%CI,
252.71-318.92).
Indirect costs were
significantly higher
in older patients
(41-65 years,
405.08; 95%CI,
348.97-461.19),
patients with more
severe disease
(698.95; 95%CI,
588.63-809.27), and
patients with more
poorly controlled
asthma (466.86;
95%CI,
414.39-519.33).
The average cost of
health care units
per patient for each
3-month period was
1317.30 (95%CI,
1151.34-1483.26).
Indirect costs were
significantly higher
in older patients
(2104.00 in
patients aged 18-40
vs 3301.55 in
patients aged
41-65), in northern
and
central regions, in
severe disease
(2921.63), and in
more poorly
controlled asthma
(1799.42).
Conclusion:
Our findings could
prove useful for
physicians and
health care
providers.
Key words:
Asthma costs. Health
care utilization.
LWDE. Absenteeism.
Presenteeism. ACT
(Asthma Control
Test). IMPALA
(Impact on Work
Productivity). |
