(Correcting) misdiagnoses of asthma: a cost effectiveness analysis

BMC Pulmonary Medicine

Research Article

Amanda Sumner¹  Douglas Coyle²  Smita Pakhale³  Katherine Vandemheen³  Shawn Aaron³ 

[1] Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, K1H 8L1, Ottawa, ON, Canada;Department of Epidemiology and Community Medicine, University of Ottawa, 451 Smyth Road, K1H 8M5, Ottawa, ON, Canada;University of Ottawa, and The Ottawa Hospital Research Institute, 501 Smyth Road, K1H 8L6, Ottawa, ON, Canada;

关键词: Asthma cost;    Canadian asthma cost;    asthma cost savings;    asthma secondary screening;    economic analysis;    epidemiology of asthma;   

DOI  :  10.1186/1471-2466-11-27

 received in 2010-11-09, accepted in 2011-05-23,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThe prevalence of physician-diagnosed-asthma has risen over the past three decades and misdiagnosis of asthma is potentially common. Objective: to determine whether a secondary-screening-program to establish a correct diagnosis of asthma in those who report a physician diagnosis of asthma is cost effective.MethodRandomly selected physician-diagnosed-asthmatic subjects from 8 Canadian cities were studied with an extensive diagnostic algorithm to rule-in, or rule-out, a correct diagnosis of asthma. Subjects in whom the diagnosis of asthma was excluded were followed up for 6-months and data on asthma medications and heath care utilization was obtained. Economic analysis was performed to estimate the incremental lifetime costs associated with secondary screening of previously diagnosed asthmatic subjects. Analysis was from the perspective of the Canadian healthcare system and is reported in Canadian dollars.ResultsOf 540 randomly selected patients with physician diagnosed asthma 150 (28%; 95%CI 19-37%) did not have asthma when objectively studied. 71% of these misdiagnosed patients were on some asthma medications. Incorporating the incremental cost of secondary-screening for the diagnosis of asthma, we found that the average cost savings per 100 individuals screened was $35,141 (95%CI $4,588-$69,278).ConclusionCost savings primarily resulted from lifetime costs of medication use averted in those who had been misdiagnosed.

【 授权许可】

CC BY   
© Pakhale et al; licensee BioMed Central Ltd. 2011