Correlation of financial burden with severity of asthma in children

Abstract

Introduction: Urbanisation is causing a rise in the financial burden of Asthma in children and it varies with the disease severity. Asthma has a low public health priority and is often under diagnosed and treated inappropriately. Objectives: Our aim was to correlate the financial burden of disease costs with Asthma classification. Methods: It was a prospective study of 38 patients attending paediatric pulmonology clinic in a tertiary care hospital. Details were entered in a predesigned proforma and institutional ethics committee approval was taken. Quantitative statistical analysis using mean, standard deviation and applying one way ANNOVA test was done. Results: Intermittent, mild and moderate persistent asthma were 8 (21.05%), 21(55.26%) and 9(23.68%) respectively. Majority of the patients;19 (50%) belonged to the upper middle class.The direct mean costs across severities ranged between INR 5700-7400 for general practitioner consultation, INR 3550-10300 for emergency visits, INR 4500-9000 for investigations and INR 7000-13700 for medications. The indirect costs ranged between INR 9000-19800 on daily wages lost, INR 2900-8700 on travel expenses (significant p value<0.014) between mild and moderate persistent asthma. Mean costs on food ranged between INR 1700-3200, tuitions INR 3000-5700 and miscellaneous expenditure being INR 2000-8300.The percentage of annual income spent was 28.76%, 40.99% and 60.64% in intermittent, mild and moderate persistent asthma respectively. Conclusion: Early referral, diligent counselling, physician and parents education along with good compliance would impart effective control and thereby reduce economic burden.