Abstract
BackgroundThere are a lack of reliable data on the epidemiology and associated burden and costs of asthma. We sought to provide the first UK-wide estimates of the epidemiology, healthcare utilisation and costs of asthma.MethodsWe obtained and analysed asthma-relevant data from 27 datasets: these comprised national health surveys for 2010–11, and routine administrative, health and social care datasets for 2011–12; 2011–12 costs were estimated in pounds sterling using economic modelling.ResultsThe prevalence of asthma depended on the definition and data source used. The UK lifetime prevalence of patient-reported symptoms suggestive of asthma was 29.5 % (95 % CI, 27.7–31.3; n = 18.5 million (m) people) and 15.6 % (14.3–16.9, n = 9.8 m) for patient-reported clinician-diagnosed asthma. The annual prevalence of patient-reported clinician-diagnosed-and-treated asthma was 9.6 % (8.9–10.3, n = 6.0 m) and of clinician-reported, diagnosed-and-treated asthma 5.7 % (5.7–5.7; n = 3.6 m). Asthma resulted in at least 6.3 m primary care consultations, 93,000 hospital in-patient episodes, 1800 intensive-care unit episodes and 36,800 disability living allowance claims. The costs of asthma were estimated at least £1.1 billion: 74 % of these costs were for provision of primary care services (60 % prescribing, 14 % consultations), 13 % for disability claims, and 12 % for hospital care. There were 1160 asthma deaths.ConclusionsAsthma is very common and is responsible for considerable morbidity, healthcare utilisation and financial costs to the UK public sector. Greater policy focus on primary care provision is needed to reduce the risk of asthma exacerbations, hospitalisations and deaths, and reduce costs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-016-0657-8) contains supplementary material, which is available to authorized users.
Highlights
There are a lack of reliable data on the epidemiology and associated burden and costs of asthma
Incidence We estimated that the annual age-standardised incidence of GP-diagnosed asthma was 3.8/1000, equivalent to approximately 240,000 people in the United Kingdom (UK) developing asthma in 2011–12
Equivalent to 9.8 m people; annual prevalence of patientreported clinician-diagnosed symptomatic asthma was 8.1 %, which equated to 5.1 m people; annual prevalence of patient-reported clinician-diagnosedand-treated asthma was 9.6 %, which equated to 6.0 m people; annual prevalence of clinician-reported-and-diagnosed asthma was 5.7 %, which equated to 3.6 m people; clinician-reported-diagnosed-and-treated asthma was 6.8 %, which equated to 4.3 m people
Summary
There are a lack of reliable data on the epidemiology and associated burden and costs of asthma. Given that asthma was highlighted as the major contributor to the estimated burden and costs, there is a particular need for a more up-to-date and detailed review of the burden, healthcare utilisation and costs, and outcomes of asthma [5]. This need was underscored by the recent National Review of Asthma Deaths, which concluded that “46 % of asthma deaths could have been avoided with better routine care” [6]. In undertaking the present study, we sought to overcome important limitations of our previous studies [2,3,4] by extending the scope from healthcare costs alone to include wider societal costs and by incorporating data from previously unavailable datasets; these included out-ofhours care, ambulance, accident and emergency (A&E), intensive care unit (ICU) utilisation, and disability living allowance (DLA) data
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