The Economic Burden of Medical Treatment of Children with Asthma in China: Real-World Evidence from the Chinese Medical Insurance Database Network (Preprint)

Abstract

The incidence of asthma has been increasing worldwide, leading to an increase in its global burden. But there are few studies on the economic burden of children with asthma in China.

To investigate the economic burden of medical treatment of children with asthma in China.

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.

The annual per capita direct medical cost related to all causes of medical visits was RMB$ 2,889 (US$411), and of that, RMB $525 (US$75) was related to asthma. The percentages of medical cost covered by insurance for all causes and asthma in China were 67% and 58%, respectively. The cost of medication accounted for the highest percentage of direct medical costs. The cost of asthma medication accounted for the highest percentage of all medication costs, followed by the cost of antibiotics. The rate of using antibiotics during asthma attack was 50.3%. In each subgroup, the highest rates of using antibiotics were central region of China (100.0%), children aged 3 years and under (63.6%), and fourth-tier and fifth-tier cities (77.1%). Patients were tested by pulmonary function test (12.2%), and allergen test (5.8%) during treatment. Outpatient clinics(98.58% vs 1.42%, P <.01), advanced 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, mid-level and primary as well as the specialized clinics, respectively.

The economic burden of childhood asthma in China is relatively high, but the national medical insurance reduces their economic burden to a large extent. Based on our findings, there remains 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 hospitalization time, and ultimately reducing the economic burden of children with asthma.