적절하게 조절되지 않는 중증 천식환자에서 급성 악화 유형과 사망 및 의료비 발생 현황

Types of Exacerbation, Case-fatality and Medical Costs in Patients with Severe and Uncontrolled Asthma

Patients with severe and uncontrolled asthma are at high risk for severe exacerbation and death, and are known to have significantly more health care utilization than well-controlled patients. This study aims to report types of exacerbation, case-fatality and medical costs in patients with severe and uncontrolled asthma. We used Health Insurance Review and Assessment Service-National Patient Sample 2016~2017. Four types of exacerbation were defined: exacerbation requiring corticosteroid burst, exacerbation requiring emergency room visit, exacerbation requiring general ward admission, and exacerbation requiring intensive care unit (ICU) admission. The 28 day case-fatality was calculated for exacerbation requiring general ward and ICU admission, respectively. The medical cost by types of exacerbation were calculated as total medical cost incurred during the exacerbation episodes. The 28 day case-fatalities for exacerbation requiring general ward and ICU admission were 0.033 and 0.167, respectively. The medical cost per episode of the above four exacerbations were 78,818 Korean won (KRW), 561,832 KRW, 1,923,265 KRW and 11,215,063 KRW, respectively. We reported types of exacerbation, 28 day case-fatality and medical costs in patients with severe and uncontrolled asthma. This study was significant because it clearly defined and distinguished the patient group and each exacerbation episodes.