State-level medical and absenteeism cost of asthma in the United States

ABSTRACT

Objective: For medically treated asthma, we estimated prevalence, medical and absenteeism costs, and projected medical costs from 2015 to 2020 for the entire population and separately for children in the 50 US states and District of Columbia (DC) using the most recently available data. Methods: We used multiple data sources, including the Medical Expenditure Panel Survey, U.S. Census Bureau, Kaiser Family Foundation, Medical Statistical Information System, and Current Population Survey. We used a two-part regression model to estimate annual medical costs of asthma and a negative binomial model to estimate annual school and work days missed due to asthma. Results: Per capita medical costs of asthma ranged from $1,860 (Mississippi) to $2,514 (Michigan). Total medical costs of asthma ranged from $60.7 million (Wyoming) to $3.4 billion (California). Medicaid costs ranged from $4.1 million (Wyoming) to $566.8 million (California), Medicare from $5.9 million (DC) to $446.6 million (California), and costs paid by private insurers ranged from $27.2 million (DC) to $1.4 billion (California). Total annual school and work days lost due to asthma ranged from 22.4 thousand (Wyoming) to 1.5 million days (California) and absenteeism costs ranged from $4.4 million (Wyoming) to $345 million (California). Projected increase in medical costs from 2015 to 2020 ranged from 9% (DC) to 34% (Arizona). Conclusion: Medical and absenteeism costs of asthma represent a significant economic burden for states and these costs are expected to rise. Our study results emphasize the urgency for strategies to strengthen state level efforts to prevent and control asthma attacks.

KEYWORDS:

• Prevalence
• medical expenditure
• missed school days
• payer

Acknowledgments

We thank Linda Thomas-Houston and Maureen Wilce for their comments and support of this project.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article. The findings and conclusions of the article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

Funding

This study was supported by the Centers for Disease Control and Prevention (Contract 200-2015-M-62811).

ORCID

Olga Khavjou http://orcid.org/0000-0003-0805-0769

Louise Murphy http://orcid.org/0000-0002-8024-9038