Length of Stay and Costs for Asthma Patients by Hospital Characteristics—A Five-Year Population-Based Analysis

Lin, Herng-Ching; Kao, Senyeong; Wen, Hsyien-Chia; Wu, Chuan-Song; Chung, Chi-Li

doi:10.1080/02770900500214783

Cited by 16 publications

(12 citation statements)

References 28 publications

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“…The significant relationship between longer LOS and higher costs, as reported here, has also been previously documented 12 . Decreasing asthma‐specific LOS has been identified as a primary factor in the preservation of hospital resources and reduction of costs 5 .…”

Section: Discussionsupporting

confidence: 81%

Cost of hospitalizing asthma patients in a regional hospital in Thailand

Chuesakoolvanich

2007

Respirology

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Cost of hospitalizing asthma patients in a regional hospital in Thailand CHUESAKOOLVANICH K. Respirology 2007; 12: [433][434][435][436][437][438] Background and objective: The hospitalization of asthma patients accounts for substantial costs in any health-care system. However, the utilization of medical resources and the cost of hospitalizing asthma patients in Thailand have never been evaluated. This study aimed to evaluate the utilization of health-care resources and itemize the cost of hospitalizing asthma patients in a regional hospital in north-east Thailand. Methods: A cross-sectional, retrospective study was conducted at Surin Hospital, a 697-bed, regional hospital in north-east Thailand. The study included 183 adults (≥15 years of age) who were admitted with acute asthma. Demographic data, resource-utilization parameters and itemized costs were recorded. Results: The average hospital cost was TH 5809.3 ± 6587.4 (US$134.5 ± 152.5) per patient (range, TH 740-57 980 or US$17.1-1342.1). Medications were the primary hospital expense (47.2%), followed by hospital charges (13.5%), nursing care (13.0%) and respiratory therapy (12.2%). Fifteen per cent of patients accounted for 45% of total hospital costs. Significant predictors of increased total hospital cost were: (i) age ≥60 years; (ii) presence of comorbid conditions; (iii) admission to the intensive care unit; and/or (iv) prolonged hospital stay. Conclusion: Despite the low unit costs for inpatient care in Thailand, the cost of hospitalizing asthma patients (especially the elderly) constitutes a substantial burden to the health-care system.

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Section: Discussionsupporting

confidence: 81%

Cost of hospitalizing asthma patients in a regional hospital in Thailand

Chuesakoolvanich

2007

Respirology

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“…Length of stay (LOS) and costs per discharge were studied from the Taiwan National Health Insurance Research Database covering the period from 1997 to 2001. [18] Study subjects were identified from the database by principal diagnosis of asthma or asthmatic bronchitis, with a total of 139,630 cases being included in the study. Multiple regression analyses were performed to explore the relationship between LOS, costs per discharge and hospital characteristics, adjusting for age, gender, and discharge status of patients, as well as complications or comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Role of health education and self-action plan in improving the drug compliance in bronchial asthma

Gaude

Hattiholi

Chaudhury

2014

J Family Med Prim Care

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Background:Considering the prevalence and associated burden of disease due to bronchial asthma, it is mandatory to obtain an optimal control of the disease and to improve outcomes for these patients. But it has been observed that there is very poor adherence to the inhalational therapy which leads to the suboptimal control of the disease.Objectives of the Study:To study the adherence for aerosol therapy in bronchial asthma patients and to assess the impact of health education and self-action plan in improving the compliance to the therapy.Methodology:A prospective study was done in a total of 500 bronchial asthma patients over a period of 2 years. Once included in the study, the patients were followed-up for a total of 12 weeks for calculation of nonadherence to the aerosol therapy. In nonadherent patients, we employed various health education strategies to improve the compliance in these cases.Results:A total of 500 patients of bronchial asthma who were started on aerosol therapy over duration of 2 years were included in the study. At the end of 12 weeks, it was observed that, only 193 patients (38.6%) had regular compliance and 307 patients (61.4%) were noncompliant to aerosol therapy as prescribed for bronchial asthma. Factors that were associated with poor compliance were: Lower educational level status, poor socioeconomic status, cumbersome regimens, dislike of medication, and distant pharmacies. Nondrug factors that reduced the compliance were: Fears about side effects, anger about condition or its treatment, forgetfulness or complacency, and patient's ill attitudes toward health. After employing the various strategies for improving the compliance in these patients, the compliance increased in 176 patients (57.3%) among the earlier defaulted patients, while the remaining 131 patients (42.7%) were found to be noncompliant even after various educational techniques.Conclusion:Noncompliance in asthma management is a fact of life and no single compliance improving strategy probably will be as effective as a good physician-patient relationship. Optimal self-management allowing for optimization of asthma control by adjustment of medications may be conducted by either self-adjustment with the aid of a written action plan or by regular medical review. Individualized written action plans based on peak expiratory flow are equivalent to action plans based on symptoms.

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“…Our findings should be viewed in light of the conclusions of a study conducted by Lin et al in Taiwan, which found that asthma patients admitted to medical centers had longer LOS and higher costs than those admitted to district hospitals. 24 However, this phenomenon may be partially explained by the tendency of medical centers to receive a relatively higher proportion of patients suffering from more serious illnesses than district hospitals. Although advanced adjustments were made in the present study for patients with preexisting comorbidi- ties and for inhospital complications, the administrative database is limited in its ability to account for differences in severity of ischemic heart disease among patients.…”

Section: Discussionmentioning

confidence: 92%