Results in increased frequency of asthma-related hospitalizations in children age 5 or older
Higher out-of-pocket expenses are tied to a slight reduction in use of asthma medications in children aged 5 years or older, which results in increased hospitalizations, according to a study published in the March 28 issue of the Journal of the American Medical Association.
Pinar Karaca-Mandic, Ph.D., of the University of Minnesota in Minneapolis, and colleagues retrospectively analyzed insurance claims for 8,834 U.S. children with asthma who initiated asthma control therapy between 1997 and 2007.
The researchers found that, during one year of follow-up for the 5,913 children aged 5 to 18 years, 121 children (2.1 percent) had an asthma-related hospitalization and 220 (3.7 percent) had an emergency department visit. Among 2,921 children younger than 5 years, 136 children (4.7 percent) had an asthma-related hospitalization and 231 (7.9 percent) had an emergency department visit. An increase in out-of-pocket medication costs from the 25th to the 75th percentile was associated with a significant reduction in adjusted medication use among older children (41.7 versus 40.3 percent of days), but no change was seen for younger children. Adjusted rates of asthma-related hospitalization were significantly higher for older children in the top quartile of out-of-pocket costs (2.4 hospitalizations per 100 children versus 1.7 per 100 in the bottom quartile), but not for younger children. Annual adjusted rates of emergency department use did not vary across out-of-pocket quartiles for either age group.
"Greater cost sharing for asthma medications was associated with a slight reduction in medication use and higher rates of asthma hospitalization among children aged 5 years or older," the authors write.
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