Cost-benefit impact of free asthma medication provision for the pediatric population.

Abstract:

BACKGROUND:Asthma is a common chronic disease in childhood, resulting in high costs for health care systems and society. As of June 2011, the Brazilian Unified Health System (SUS) provides free asthma medications for the population. This study evaluated the impact of this program on asthma admissions in the population aged 1-19 years. In addition, a cost-benefit analysis compared data before and after the introduction of the program. METHODS:This descriptive study was based on information from SUS Information Technology Department (DATASUS). Admission rates and costs of patients aged 1-19 years with diagnosed asthma were compared before (2008-2010) and after (2012-2017) the provision of free inhaled corticosteroid. RESULTS:The asthma admission rate reduced by 28.4% when comparing the two periods (OR 0.71; 95% CI 0.64-0.79). Children aged 1-4 years had a 27.3% reduction in asthma admissions (OR 0.72; 95% CI 0.63-0.82), while those aged 15-19 years had a 39.65% decrease (OR 0.59; 95% CI 0.37-0.95). Asthma admission costs decreased when comparing the two periods (OR 0.68; 95% CI 0.62-0.74). After the introduction of the program, mean cost savings reached US $27,865,905.08 in children aged 1-4 years and US $21,350,660.63 in those aged 5-19 years. CONCLUSION:The economic burden of pediatric asthma on Brazil's public health care system is significant. From 2012 to 2015, free provision of inhaled corticosteroid was cost-effective in all age groups. In 2017, no cost-benefit effect was observed in this population, but asthma admission rate decreased.

journal_name

Respir Med

journal_title

Respiratory medicine

authors

Koltermann V,Friedrich FO,Fensterseifer AC,Ongaratto R,Pinto LA

doi

10.1016/j.rmed.2020.105915

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

105915

eissn

0954-6111

issn

1532-3064

pii

S0954-6111(20)30055-X

journal_volume

164

pub_type

杂志文章
  • Primary biphasic synovial sarcoma of the pleura.

    abstract::Synovial sarcoma most commonly occurs in the peri-articular regions of the extremities. The present report describes a rare case of primary biphasic synovial sarcoma of the pleura in an 18-year-old female. The diagnosis was made on the basis of light microscopy, immunohistochemistry, electron microscopy and the charac...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/s0954-6111(97)90093-7

    authors: Jawahar DA,Vuletin JC,Gorecki P,Persechino F,Macera M,Magazeh P

    更新日期:1997-10-01 00:00:00

  • Exercise oxygen flow titration methods in COPD patients with respiratory failure.

    abstract::We compare the adequacy of several titration procedures of oxygen flow in maintaining SpO(2) > 90% during the activities of daily life in patients with very severe COPD. Thirty-one very severe COPD patients undergoing oxygen-therapy were recruited. Three titration methods were randomly performed: (1) 6-min walking tes...

    journal_title:Respiratory medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.rmed.2012.06.021

    authors: Galera R,Casitas R,Martínez E,Lores V,Rojo B,Carpio C,Llontop C,García-Río F

    更新日期:2012-11-01 00:00:00

  • Airway and alveolar nitric oxide measurements in obstructive sleep apnea syndrome.

    abstract:STUDY OBJECTIVES:The process of intermittent hypoxia-reoxygenation produces airway inflammation and endothelial dysfunction that favors the development of cardiovascular disorders in obstructive sleep apnea syndrome (OSAS). Nitric oxide (NO) is an important mediator in airway inflammation and the regulation of endothel...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2010.12.004

    authors: Fortuna AM,Miralda R,Calaf N,González M,Casan P,Mayos M

    更新日期:2011-04-01 00:00:00

  • Cost of influenza and influenza-like syndromes (I-LSs) in Italy: Results of a cross-sectional telephone survey on a representative sample of general population.

    abstract:OBJECTIVES:Influenza and Influenza-like syndromes (I-LSs) are very common events in general practice, and their relevance is frequently underestimated. Aim of the study was to assess the economic impact of influenza and Influenza-like syndromes (I-LSs) in the Italian general population by using real-world data from a r...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2018.07.001

    authors: Dal Negro RW,Turco P,Povero M

    更新日期:2018-08-01 00:00:00

  • Relative responsiveness of the Chronic Respiratory Questionnaire, St. Georges Respiratory Questionnaire and four other health-related quality of life instruments for patients with chronic lung disease.

    abstract:BACKGROUND:Selection of heath-related quality of life (HRQL) instruments that are most responsive to changes in HRQL prevents investigators from drawing false-negative conclusions about the effectiveness of an intervention. The objective of this study was to compare the responsiveness of the Chronic Respiratory Questio...

    journal_title:Respiratory medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1016/j.rmed.2006.04.023

    authors: Puhan MA,Guyatt GH,Goldstein R,Mador J,McKim D,Stahl E,Griffith L,Schünemann HJ

    更新日期:2007-02-01 00:00:00

  • A study on infectivity of asymptomatic SARS-CoV-2 carriers.

    abstract:BACKGROUND:An ongoing outbreak of coronavirus disease 2019 (COVID-19) has spread around the world. It is debatable whether asymptomatic COVID-19 virus carriers are contagious. We report here a case of the asymptomatic patient and present clinical characteristics of 455 contacts, which aims to study the infectivity of a...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2020.106026

    authors: Gao M,Yang L,Chen X,Deng Y,Yang S,Xu H,Chen Z,Gao X

    更新日期:2020-08-01 00:00:00

  • Impact of pulmonary hypertension on gas exchange and exercise capacity in patients with pulmonary fibrosis.

    abstract::Pulmonary hypertension is a relevant interceding morbidity in patients with pulmonary fibrosis that has significant impact on exercise tolerance and outcome. The aim of this study was to further characterize the exercise intolerance, dyspnoea and ventilatory inefficiency of patients with pulmonary fibrosis in the pres...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2008.08.005

    authors: Gläser S,Noga O,Koch B,Opitz CF,Schmidt B,Temmesfeld B,Dörr M,Ewert R,Schäper C

    更新日期:2009-02-01 00:00:00

  • Omalizumab-induced decrease of FcξRI expression in patients with severe allergic asthma.

    abstract:BACKGROUND:It is documented that omalizumab treatment reduces the cell surface expression of immunoglobulin E high-affinity receptor (FcɛRI) on several cell types. This has not been investigated in patients with uncontrolled severe persistent allergic asthma. METHODS:In a double-blind, randomized, placebo-controlled s...

    journal_title:Respiratory medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1016/j.rmed.2010.07.011

    authors: Chanez P,Contin-Bordes C,Garcia G,Verkindre C,Didier A,De Blay F,de Lara MT,Blanco P,Moreau JF,Robinson P,Bourdeix I,Trunet P,Le Gros V,Humbert M,Molimard M

    更新日期:2010-11-01 00:00:00

  • Aminophylline toxicity--how many hospital asthma deaths does it cause?

    abstract::Aminophylline administration was compared in 43 patients who died from asthma and 43 matched controls who were admitted, suffering from acute asthma, to hospitals in the North East Thames Region. A computer program, which used information about individual characteristics, medical history and drug intake, was employed ...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/s0954-6111(89)80035-6

    authors: Eason J,Markowe HL

    更新日期:1989-05-01 00:00:00

  • Altered antioxidant status in peripheral skeletal muscle of patients with COPD.

    abstract::Despite the growing field of interest in the role of pulmonary oxidative stress in chronic obstructive pulmonary disease (COPD), barely any data are available with respect to antioxidant capacity in the peripheral musculature of these patients. The main objective of this study was to assess in detail the antioxidant s...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2004.05.018

    authors: Gosker HR,Bast A,Haenen GR,Fischer MA,van der Vusse GJ,Wouters EF,Schols AM

    更新日期:2005-01-01 00:00:00

  • Tracheal collapsibility in adults is dynamic over time.

    abstract:BACKGROUND:Tracheal collapse is a weakness of the tracheal wall leading to expiratory central airway collapse of more than 50% compared to inspiration. It has previously been discussed whether the collapsibility of the greater airways is a stable or a dynamic condition. Indeed, other well-known lung diseases such as as...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2018.11.018

    authors: Nygaard M,Hilberg O,Rasmussen F,Bendstrup E

    更新日期:2019-01-01 00:00:00

  • Inspired fraction of carbon dioxide in oxygen supply to chronic pulmonary disease.

    abstract::Hypoxemic patients with chronic obstructive pulmonary disease (COPD) are at risk of carbon dioxide (CO(2)) retention during oxygen therapy and hypercapnia in COPD is associated with an ominous prognosis. Rebreathing with oxygen mask is possible in practice and possibly affects CO(2) retention due to an increased inspi...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2008.08.015

    authors: Fremault A,Silva M,Beaucage F,Berckmans D,Decramer M

    更新日期:2008-12-01 00:00:00

  • Ethnic and racial differences in the presence of idiopathic pulmonary fibrosis at death.

    abstract:BACKGROUND:In studies of idiopathic pulmonary fibrosis (IPF), whites makeup the vast majority of subjects. Whether ethnic/racial differences in idiopathic pulmonary fibrosis occur in the general population is unknown. METHODS:To compare the presence of IPF between ethnic/racial groups of U.S. decedents from 1989 to 20...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2012.01.002

    authors: Swigris JJ,Olson AL,Huie TJ,Fernandez-Perez ER,Solomon J,Sprunger D,Brown KK

    更新日期:2012-04-01 00:00:00

  • Sarcoidosis-associated small fiber neuropathy in a large cohort: Clinical aspects and response to IVIG and anti-TNF alpha treatment.

    abstract:OBJECTIVE:Small fiber neuropathy commonly affects patients with sarcoidosis and is often refractory to standard immunosuppressive therapies used for systemic disease. The clinical features of sarcoidosis-associated small fiber neuropathy (SSFN) and its response to medical therapy have not been described in a large popu...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2017.03.011

    authors: Tavee JO,Karwa K,Ahmed Z,Thompson N,Parambil J,Culver DA

    更新日期:2017-05-01 00:00:00

  • Exhaled nitric oxide: independent effects of atopy, smoking, respiratory tract infection, gender and height.

    abstract::Measurement of exhaled nitric oxide is widely used in respiratory research and clinical practice, especially in patients with asthma. However, interpretation is often difficult, due to common interfering factors, and little is known about interactions between factors. We assessed the influences and interactions of fac...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2008.02.012

    authors: Dressel H,de la Motte D,Reichert J,Ochmann U,Petru R,Angerer P,Holz O,Nowak D,Jörres RA

    更新日期:2008-07-01 00:00:00

  • Systemic inflammatory response to exhaustive exercise in patients with chronic obstructive pulmonary disease.

    abstract::Systemic inflammation may be present in patients with chronic obstructive pulmonary disease (COPD). Exercise is known to elicit an inflammatory response. We hypothesized that the systemic inflammatory response to exercise might be exaggerated in COPD patients compared to healthy subjects. Sixteen COPD patients and 11 ...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2005.03.028

    authors: van Helvoort HA,van de Pol MH,Heijdra YF,Dekhuijzen PN

    更新日期:2005-12-01 00:00:00

  • The natural history of non-cavitary nodular bronchiectatic Mycobacterium avium complex lung disease.

    abstract:PURPOSE:We aimed to investigate the natural history of non-cavitary nodular bronchiectatic (NC-NB) Mycobacterium avium complex (MAC) lung disease (LD). METHODS:Among all patients diagnosed with NC-NB MAC LD between March 2000 and December 2013, 551 patients who were followed until December 2017 were enrolled at a tert...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2019.02.007

    authors: Kwon BS,Lee JH,Koh Y,Kim WS,Song JW,Oh YM,Lee SD,Lee SW,Lee JS,Lim CM,Choi CM,Huh JW,Hong SB,Shim TS,Jo KW

    更新日期:2019-04-01 00:00:00

  • Infection control of lung function equipment: a practical approach.

    abstract::The degree of risk of cross-infection of patients via lung function testing equipment has yet to be quantified. Based on current evidence, elaborate precautions are not justified for the majority of patients attending the laboratory, but attention to appropriate routine cleaning and disinfection protocols is important...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/s0954-6111(03)00223-3

    authors: Kendrick AH,Johns DP,Leeming JP

    更新日期:2003-11-01 00:00:00

  • Regular albuterol or nedocromil sodium--effects on airway subepithelial tenascin in asthma.

    abstract::Both albuterol and nedocromil sodium have been recognized to possess certain anti-inflammatory properties. However, there are no data on the impact of these drugs on the pathophysiology of the bronchial extracellular matrix in asthma characterized by enhanced tenascin (Tn) expression, known to occur proportional to th...

    journal_title:Respiratory medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0954-6111(99)90086-0

    authors: Altraja A,Laitinen A,Meriste S,Marran S,Märtson T,Sillastu H,Laitinen LA

    更新日期:1999-07-01 00:00:00

  • Human neutrophil lipocalin (HNL) and myeloperoxidase (MPO). Studies of lung lavage fluid and lung tissue.

    abstract::Myeloperoxidase (MPO) and human neutrophil lipocalin (HNL) are proteins which are stored in neutrophil granulocytes, in the primary and secondary granules, respectively. These granules or their contents of MPO and HNL are secreted upon activation of the cells, and measurement of these soluble markers in biological flu...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1053/rmed.2000.0776

    authors: Schmekel B,Seveus L,Xu SY,Venge P

    更新日期:2000-06-01 00:00:00

  • Incidence of tuberculosis among anti-tumor necrosis factor users in patients with a previous history of tuberculosis.

    abstract:BACKGROUND:We aimed to investigate the results of anti-tumor necrosis factor (TNF) therapy in patients with a previous history of tuberculosis (TB). METHODS:A total of 101 patients with a previous history of TB receiving TNF antagonists between December 2004 and September 2012 at the Asan Medical Center in South Korea...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2013.08.011

    authors: Jo KW,Hong Y,Jung YJ,Yoo B,Lee CK,Kim YG,Yang SK,Byeon JS,Kim KJ,Ye BD,Lee SD,Kim WS,Kim DS,Shim TS

    更新日期:2013-11-01 00:00:00

  • Smoking, obesity and risk of sarcoidosis: A population-based nested case-control study.

    abstract:BACKGROUND:Smoking and obesity might alter the risk of sarcoidosis. However, the data remained inconclusive. METHODS:A cohort of Olmsted County, Minnesota residents diagnosed with sarcoidosis between January 1, 1976 and December 31, 2013 was identified based on individual medical record review. For each sarcoidosis su...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2016.10.003

    authors: Ungprasert P,Crowson CS,Matteson EL

    更新日期:2016-11-01 00:00:00

  • The expression of pro- and anti-apoptotic Bcl-2 family proteins in peribronchiolar lymphocytes from patients with diffuse panbronchiolitis.

    abstract::Diffuse panbronchiolitis (DPB) is a distinctive form of small airway disease, which is characterized by chronic inflammation with lymphocyte infiltration around bronchioles. The aim of this study was to evaluate the importance of factors related to apoptosis in peribronchiolar lymphocytes of DPB. We employed immunohis...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2006.02.011

    authors: Kadota J,Mizunoe S,Mukae H,Mito K,Kishi K,Tokimatsu I,Nagai H,Tomono K,Kohno S,Nasu M

    更新日期:2006-11-01 00:00:00

  • Factors associated with pulmonary hypertension and long-term survival in bronchiectasis subjects.

    abstract:BACKGROUND:The development of pulmonary hypertension (PH) and its effect on long-term survival in bronchiectasis subjects has not been explored. The present study aims to analyze the factors associated with PH and its effect on long-term survival in bronchiectasis subjects. METHODS:We prospectively evaluated 23 bronch...

    journal_title:Respiratory medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.rmed.2016.08.027

    authors: Öcal S,Portakal O,Öcal A,Demir AU,Topeli A,Çöplü L

    更新日期:2016-10-01 00:00:00

  • Factors related to tobacco use among teenagers.

    abstract:AIM:To examine tobacco use among teenagers, identify factors related to tobacco use, as well as evaluate the outcome of a smoking prevention program. METHODS:From age 7/8 to 14/15, annual questionnaires about asthma and allergy have been completed in the OLIN paediatric study in Northern Sweden. From 12/13 years, ques...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2006.07.001

    authors: Hedman L,Bjerg A,Perzanowski M,Sundberg S,Rönmark E

    更新日期:2007-03-01 00:00:00

  • Hydrofluoroalkane-134a beclomethasone dipropionate extrafine aerosol provides equivalent asthma control to chlorofluorocarbon beclomethasone dipropionate at approximately half the total daily dose.

    abstract::The mandatory requirement to eliminate chlorofluorocarbons (CFCs) as propellants in pharmaceutical aerosols has provided the opportunity to enhance significantly the delivery of aerosol drugs to the respiratory tract. This randomized, parallel-group, double-blind, double-dummy, multicentre study was undertaken to asse...

    journal_title:Respiratory medicine

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1016/s0954-6111(98)90214-1

    authors: Davies RJ,Stampone P,O'Connor BJ

    更新日期:1998-06-01 00:00:00

  • A comprehensive approach to lung function in bronchiectasis.

    abstract:BACKGROUND:International guidelines recommend simple spirometry for bronchiectasis patients. However, pulmonary pathophysiology of bronchiectasis is very complex and still poorly understood. Our objective was to characterize lung function in bronchiectasis and identify specific functional sub-groups. METHODS:This was ...

    journal_title:Respiratory medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.rmed.2018.10.031

    authors: Radovanovic D,Santus P,Blasi F,Sotgiu G,D'Arcangelo F,Simonetta E,Contarini M,Franceschi E,Goeminne PC,Chalmers JD,Aliberti S

    更新日期:2018-12-01 00:00:00

  • Delayed referral reduces the success of video-assisted thoracoscopic surgery for spontaneous pneumothorax.

    abstract:BACKGROUND:Video-assisted thoracoscopic surgery (VATS) is now the generally preferred surgical treatment for spontaneous pneumothorax but is more difficult once pleural adhesions have developed. To test the hypothesis that VATS is under-used because of prolonged pleural intubation, we have audited the effect of preoper...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/s0954-6111(98)90103-2

    authors: Waller DA,McConnell SA,Rajesh PB

    更新日期:1998-02-01 00:00:00

  • Idiopathic chronic cough and organ-specific autoimmune diseases: a case-control study.

    abstract::The marked female predominance in cases of idiopathic chronic cough and its association with mild chronic lymphocytic airway inflammation suggests an underlying autoimmune process. We set out to test the hypothesis that idiopathic chronic cough is associated with other organ-specific autoimmune diseases in a case cont...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2003.10.005

    authors: Birring SS,Murphy AC,Scullion JE,Brightling CE,Browning M,Pavord ID

    更新日期:2004-03-01 00:00:00

  • Oral bacteria--the missing link to ambiguous findings of exhaled nitrogen oxides in cystic fibrosis.

    abstract:BACKGROUND:Nitrite in exhaled breath condensate (EBC) has been shown to be elevated in cystic fibrosis (CF), while exhaled nitric oxide (FENO) is paradoxically low. This has been argued to reflect increased metabolism of NO while its diffusion is obstructed by mucus. However, we wanted to study the possible influence o...

    journal_title:Respiratory medicine

    pub_type: 杂志文章

    doi:10.1016/j.rmed.2008.09.009

    authors: Zetterquist W,Marteus H,Kalm-Stephens P,Näs E,Nordvall L,Johannesson M,Alving K

    更新日期:2009-02-01 00:00:00