Health care costs associated with acute asthma: a prospective economic analysis

To determine the direct and indirect costs associated with the care of acute asthma in an adult teaching hospital.

A prospective, cost identification study.

Patients aged 15 to 55 years presenting with acute asthma. Consecutive emergency department visits for asthma at Vancouver Hospital and Health Sciences Centre over six months were prospectively monitored. The duration of hospital stay, physician's care, laboratory procedures and medication given were recorded. Time lost from work or school was determined by follow-up telephone calls. The costs were calculated in 1997 Canadian dollars.

One hundred and forty-nine patients made 195 emergency department visits over the six-month study. Twenty-eight (14%) of these visits led to hospital admissions. The total cost associated with the care of these patients was $250,570. The median (standard deviation in brackets) direct medical costs associated with each emergency department visit and hospital day were $324.00 (+/-52.00) per visit, and $677.00 (+/-76.00) per day, respectively.

The present study provides a more accurate estimation of the operational cost of managing asthma in a teaching hospital setting than previous studies. The data presented in this study can be used in future cost effectiveness and cost-benefit studies in acute asthma, particularly where these studies involve specific intervention such as asthma education. More studies, which include children with asthma and patients treated outside of the hospital setting, are needed.