Smoking makes asthma expensive: a register-based study in Finland

• Published in: The international journal of tuberculosis and lung disease Vol. 11; no. 12; pp. 1358 - 1365
• Main Authors: IKÄHEIMO, P, TUUPONEN, T, KIUTTU, J, HAKKO, H, HARTIKAINEN, S, KLAUKKA, T
• Format: Journal Article
• Language: English
• Published: Paris, France IUATLD 01.12.2007; Union internationale contre la tuberculose et les maladies respiratoires
• Subjects: Activities of Daily Living; Adult; Aged; Asthma; Asthma - economics; Asthma - epidemiology; Asthma - physiopathology; Biological and medical sciences; Chi-Square Distribution; Chronic obstructive pulmonary disease, asthma; COPD; Costs; Female; Finland - epidemiology; Health Care Utilisation; Health Services - utilization; Humans; Logistic Models; Male; Medical sciences; Middle Aged; Miscellaneous; Mycobacterium; Pneumology; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Registries; Smoking; Smoking - economics; Smoking - epidemiology; Smoking - physiopathology; Surveys and Questionnaires; Tobacco, tobacco smoking; Toxicology; Europe; Finland; Lung disease; Costs; Respiratory disease; Tobacco smoking; Care; Asthma; Tobacco; Health economy; Specific registry; smoking; Bronchus disease; Chronic obstructive pulmonary disease; health care utilisation; Obstructive pulmonary disease; Economic aspect; Public health; Pneumology; COPD
• ISSN: 1027-3719; 1815-7920

SETTING: Chronic bronchitis and chronic obstructive pulmonary disease (COPD)/emphysema occur frequently among middle-aged and elderly asthma patients who smoke.OBJECTIVE: To test how much this comorbidity increases the use and costs of health services in comparison with asthma alone.DESIGN: A sample of 6000 adults with a clinical diagnosis of asthma was extracted from a nationwide health insurance register for a postal inquiry. Comorbidity and the use of health services were measured using a questionnaire. Data on medication expenses were obtained from the national prescription register.RESULTS: Altogether 4956 individuals replied, of whom 3160 asthma patients aged ≥40 years (response rate 85%) were chosen for this investigation. Asthma patients with COPD/emphysema (12% of the series) accounted for 21% of all doctor consultations, 39% of the total number of hospital in-patient days and 27% of the total expenses, of which one third were medication costs. The mean annual gross expenditure on treatment services and anti-asthma medications was €754 per patient for those with asthma alone and €2107 for those with concurrent COPD/emphysema. Current smoking further increased costs among COPD patients.CONCLUSION: To prevent pulmonary comorbidity and the related high costs, cessation of smoking should be an integral part of the treatment provided for asthma patients.