The Indian Journal of Pediatrics

, Volume 80, Issue 8, pp 708–709

Direct Economic Cost of Acute Asthma in Emergency Department

Authors

  • Raheleh Dashti
    • Department of Immunology, Asthma and Allergy Research InstituteTehran University of Medical Sciences
  • Mostafa Sedighy
    • Department Emergency, Children Hospital Medical CenterTehran University of Medical Sciences
    • Department of Immunology, Asthma and Allergy Research InstituteTehran University of Medical Sciences
    • Department of Immunology & Allergy, Children Hospital Medical CenterTehran University of Medical Sciences
  • Mohammad Sadegh Ahmadiani
    • School of BusinessCarlton University
  • Mohammad Reza Fazlollahi
    • Department of Immunology, Asthma and Allergy Research InstituteTehran University of Medical Sciences
  • Behrooz Bavarian
    • Department Emergency, Children Hospital Medical CenterTehran University of Medical Sciences
  • Mostafa Moin
    • Department of Immunology, Asthma and Allergy Research InstituteTehran University of Medical Sciences
    • Department of Immunology & Allergy, Children Hospital Medical CenterTehran University of Medical Sciences
Scientific Letter to the Editor

DOI: 10.1007/s12098-012-0912-8

Cite this article as:
Dashti, R., Sedighy, M., Pourpak, Z. et al. Indian J Pediatr (2013) 80: 708. doi:10.1007/s12098-012-0912-8

To the Editor: Asthma is one of the most important current respiratory diseases [1]. A world wide increase in the prevalence of asthma has been reported recently [2]. It is one of the most costly chronic diseases and contributes to a significant factor of health care services utilization, particularly emergency departments [3]. The knowledge of the cost of asthma is valuable in documenting the burden of the disease and in developing strategies for the management and health economics in future in each country [4]. Our study is the first pilot study of emergency visit during 1 y in Iran. This cross-sectional study, was performed at emergency department of a referral center in an educational hospital of Tehran (Children Hospital Medical Center of Tehran University of Medical Sciences) and assessed asthmatic children’s files who were admitted from 21 March 2008 till 21 March 2009 for asthma attack. The cost of medical care for each patient in one admission was evaluated. This study included evaluation of files of 65 asthmatic children (1–14 y;47 males and 18 females) who were admitted in the emergency ward even once during 2008 for asthma attack. The mean age of patients at the time of admission was 5 y. The mean time of management at emergency department was 5.5 h (1–24 h) and the peak time of referring was between 20 and 24 p.m.

Salbutamol, a ß2 adrenergic drug was used as the main medicine in all the patients in the form of nebulizer at least 3 times during their admission. The mean total cost for managing the asthma attack in emergency department was about 15.23 dollars, per case, per management at the emergency ward, with standard deviation of 6.92 (Fig. 1). This was the amount invoiced by emergency center to the patient and included all provided services and medications.
https://static-content.springer.com/image/art%3A10.1007%2Fs12098-012-0912-8/MediaObjects/12098_2012_912_Fig1_HTML.gif
Fig. 1

The total cost of management in emergency department for patients in one visit

At the time of this research USD (U.S. Dollar)/IRR(Iranian Rial)exchange rate was 1 USD = 10,500,00 IRR. More than 80 % of patients had health insurance support that covered 70 % of the all costs. Emergency services consisted of nursing care, medication, bed and devices and are mentioned in detail in Table 1.
Table 1

Detailed cost at emergency department in rials and dollars

Resources consumed

Mean cost ± (SD) (Rials)

Mean cost ± (SD) (Dollars)

Medication

57,303 ± 32,136

5.73 ± 3.21

Nursing care

3,114 ± 3,509

0.31 ± 0.35

Bed

51,620 ± 57,961

5.16 ± 5.79

Nebulizer

36,000 ± 1,000

3.6 ± 1

Total

152,345 ± 69,239

15.23 ± 6.92

Expenditure data represents the costs paid for medication, nursing care, doctor’s visit, bed and devices to manage acute asthma in only one visit without following up them during 1 y and without considering the indirect cost and with a limitation of small sample size.

According to the Central bank of Iran, monthly mean income of any family was 807.07 USD, and average health care costs of Iranian family in 2008–2009 was 50 USD. Also the mean cost of asthma management in emergency department is 15 USD [5].

The average cost of an ED admission of asthma attack in this pilot study is comparable to some countries as Turkey [reported in 2008 (mean cost: USD)] [6] which may be related to high support of health insurance and educational hospitals in Iran. Also Iranian government supports drugs and equipment financially.

Copyright information

© Dr. K C Chaudhuri Foundation 2012