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    Uncontrolled asthma can affect children's schooling, family income

    Failure to appropriately control severe asthma in children not only has a critical effect on their health but also impacts their educational achievement. It also doubles the health care costs related to their disease, according to results of a new study.

    Researchers found that children with “very poorly controlled” asthma missed an average of 18 days of school each year, compared with 2 or fewer for other asthma patients.

    Pediatricians’ success in “addressing medication adherence, inhaler technique, proper medications, and other asthma management strategies” can avoid those consequences, according to Stanley Szefler, MD, lead investigator and professor of pediatrics at National Jewish Health in Denver.

    “This study looks for the first time at how effective and ineffective management of severe asthma impacts cost,” Szefler said. “It highlights the toll that poorly controlled asthma takes on children. It also points to an opportunity—with proper attention and education, many, if not most, of those children could gain control over their asthma, thus reducing healthcare costs, improving their lives and their chances for success.”

    The study evaluated 628 children aged 6 to 12 years with severe or difficult-to-treat asthma over a 2-year period, at baseline, at 12 months, and at 24 months. Direct medical costs, including medications, unscheduled office and emergency visits, and hospital admissions, as well as indirect costs measured by school or work days lost were taken into consideration.

    According to the results, patients with very poorly controlled asthma at baseline incurred an average of $7,846 in costs compared with $3,526 for patients with not-well-controlled asthma and $3,766 for well-controlled asthma. By the end of the study, costs for patients with very poorly controlled asthma increased to $8,880, whereas costs for those with well-controlled asthma dropped to $1,861.

    Direct costs of care were about 50% more for poorly controlled asthma. Furthermore, assuming that at least 1 parent would have to stay home for each missed school day, researchers noted that indirect costs for very poorly controlled asthma ($3,078) were more than 8 times as great as the costs for not-well-controlled asthma ($369). With no missed school days among patients with well-controlled asthma, their indirect costs were $0.

    The financial effect may be even worse than it appears because all costs in the study are 2002 dollars, and costs in 2011 dollars would be approximately 25% more, researchers noted.

    Go back to the current issue of eConsult.

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