Healthcare expenditure and its socio-demographic and clinical predictors in Australians with poorly controlled asthma

Stella T Lartey; Thomas Lung; Sarah Serhal; Luke Bereznicki; Bonnie Bereznicki; Lynne Emmerton; Sinthia Bosnic-Anticevich; Bandana Saini; Laurent Billot; Ines Krass; Carol Armour; Stephen Jan

doi:10.1371/journal.pone.0279748

Healthcare expenditure and its socio-demographic and clinical predictors in Australians with poorly controlled asthma

PLoS One. 2023 Jan 5;18(1):e0279748. doi: 10.1371/journal.pone.0279748. eCollection 2023.

Authors

Stella T Lartey^{1

2}, Thomas Lung^{3

4}, Sarah Serhal^{5

6}, Luke Bereznicki⁷, Bonnie Bereznicki⁸, Lynne Emmerton⁹, Sinthia Bosnic-Anticevich^{5

6}, Bandana Saini^{5

6}, Laurent Billot^{3

10}, Ines Krass⁶, Carol Armour^{5

11}, Stephen Jan^{3

10}

Affiliations

¹ Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom.
² NIHR Applied Research Collaboration, East of England, United Kingdom.
³ The George Institute for Global Health, Sydney, Australia.
⁴ School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
⁵ Woolcock Institute of Medical Research, Sydney, New South Wales, Australia.
⁶ School of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia.
⁷ College of Health and Medicine, University of Tasmania, Hobart, Australia.
⁸ Tasmanian School of Medicine, Hobart, Tasmania, Australia.
⁹ Curtin Medical School, Curtin University, Perth, Western Australia, Australia.
¹⁰ Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
¹¹ Central Sydney Area Health Service, Sydney, New South Wales, Australia.

Abstract

Introduction: Asthma has substantial and increasing health and economic burden worldwide. This study aimed to estimate healthcare expenditure and determine the factors that increase expenditure in Australians with poorly controlled asthma.

Methods: Individuals ≥18 years of age with poorly controlled asthma, as determined by a score ≥1.5 on the Asthma Control Questionnaire, were included in the study. Healthcare utilization costs from medical services and medications were estimated over an average follow-up of 12 months from administratively linked data: the Medicare Benefits Schedule and Pharmaceutical Benefits Scheme. A generalized linear model with gamma distribution and log link was used to predict participants' key baseline characteristics associated with variations in healthcare costs.

Results: A total of 341 participants recruited through community pharmacies were included. The mean (standard deviation, SD) age of participants was 56.6 (SD 17.6) years, and approximately 71% were females. The adjusted average monthly healthcare expenditure per participant was $AU386 (95% CI: 336, 436). On top of the average monthly costs, an incremental expenditure was found for each year increase in age ($AU4; 95% CI: 0.78, 7), being unemployed ($AU201; 95% CI: 91, 311), one unit change in worsening quality of life ($AU35; 95% CI: 9, 61) and being diagnosed with depression and anxiety ($AU171; 95% CI: 36, 306).

Conclusions: In a cohort of Australian patients, characterized by poor asthma control and co-morbidities individuals impose substantial economic burden in terms of Medicare funded medical services and medications. Programs addressing strategies to improve the quality of life and manage co-morbid anxiety and depression and encourage asthma patients' engagement in clinically tolerable jobs, may result in significant cost savings to the health system.

Copyright: © 2023 Lartey et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Asthma* / therapy
Australia
Female
Health Care Costs
Health Expenditures*
Humans
Male
Middle Aged
National Health Programs
Quality of Life

Grants and funding

This work was supported by the Commonwealth of Australia as represented by the Department of Health via the Sixth Community Pharmacy Agreement (6CPA). The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The funders had no role in the design of the study, in the collection, analyses, or interpretation of data or in the writing of this manuscript.