Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Feb 10, 2020)
Date Submitted: Jan 17, 2020
Open Peer Review Period: Jan 17, 2020 - Jan 24, 2020
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The Economic Burden of Medical Treatment of Children with Asthma in China: Real-World Evidence from the Chinese Medical Insurance Database Network
ABSTRACT
Background:
It is estimated that there are at least 300 million asthma patients in the world, with mainland China accounting for about 10% (30 million). At present, there are few studies on the economic burden of children with asthma in China.
Objective:
To investigate the economic burden of medical treatment of children with asthma in China.
Methods:
The China Medical Insurance Research Association (CHIRA) database was searched for patients with asthma from 0 to 14 years old who were diagnosed based on the criteria of “J45” and “J46” coded in ICD-10. A cross-sectional study with cost analysis was conducted.
Results:
The annual per capita direct medical cost was RMB 525 (US$75) related to asthma. The percentages of medical cost covered by insurance for asthma in China was 58%. The cost of medication accounted for the majority of direct medical costs. The cost of asthma medication accounted for the greatest percentage of all medication costs, followed by the cost of antibiotics. The rate of using antibiotics during asthma attack was 50.3%. In subgroup analysis, those that have the highest rates of using antibiotics were central China (100.0%), children aged 3 years and under (63.6%), as well as fourth-tier and fifth-tier cities (77.1%). Patients underwent the pulmonary function test (12.2%), and allergen test (5.8%) during treatment. Outpatient clinics (98.58% vs 1.42%, P <.01), tertiary hospitals (62.08% vs 37.92%, P <.01), and general hospitals (72.27% vs 27.73%, P <.01) were more often visited than the inpatient clinics, secondary and primary as well as the specialized clinics, respectively.
Conclusions:
The economic burden of childhood asthma in China is relatively low, and the national medical insurance reduces their economic burden to a large extent. Based on our findings, there remain opportunities to strengthen the hierarchical medical system, and the Global Initiative for Asthma (GINA) program and Chinese guidelines still need to be further popularized in order to achieve complete control of asthma, thereby reducing hospitalization and emergency visits, shortening the length of hospital stay, and ultimately reducing the economic burden of children with asthma.
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