Economic burden of asthma among patients visiting a private hospital in south India

Abstract

Asthma is a major health problem with about 334 million patients being affected across the world of which 17.23 million are in India. Asthma is associated with socioeconomic burden due to both direct cost, incurred in terms of medications, hospitalizations, investigations and regular doctors visit; and indirect cost incurred in terms of productivity loss due to the foregone labour. Aim: To estimate the economic burden of asthma in terms of direct and indirect cost. Methodology: Cross sectional observation study which included patients diagnosed with asthma. Direct cost was calculated in terms of medications, doctor’s visit, investigation charges and hospitalisation due to asthma. Indirect cost was calculated in terms of lost wages, termed as absenteeism. Asthma control was assessed using the ACT questionnaire. Results: 120 patients were included. Mean annual direct cost, cost due to medications, doctors visit, investigations and hospitalisation accounted to be Indian rupees ₹18,737/yr (€258.5), ₹7,427/yr (€102.46), ₹2,089/yr (€28.82), ₹1,103/yr (€5.22), and ₹62,500/yr(€862.26) respectively. Mean annual indirect cost was ₹25,358/yr(€349.84). 47% patients had well controlled asthma. Mean annual direct and indirect cost among controlled and uncontrolled asthmatics were ₹13,010/yr(€179.49),₹23,918/yr (€329.98) {p=0.008}, ₹14,930/yr(€205.98) and ₹ 21,096/yr (€291.04) respectively {p=0.343}.An asthma patient lost an average of 17 working days in a year. Conclusion: Asthma is not only associated with patient specific impairment, but also a significant economic burden to the family and society. Productivity loss is another underappreciated source of economic loss.