BACKGROUND: Although health-related quality of life (HRQL) has been increasingly used as an outcome in asthma, its utility for identifying patients at risk for adverse asthma outcomes has not been established. OBJECTIVE: In a prospective cohort study, to evaluate the longitudinal impact of HRQL on future health care utilization and cost among adults with asthma, accounting for known risk factors for utilization. METHODS: A stratified random sample of 3,482 adult Northern CA Kaiser Permanente members with asthma was selected using computerized utilization databases and a screening survey item. Subjects completed a mail survey that included measures of generic (SF-12) and asthma-specific HRQL (ITG-Asthma Short Form battery). During the 12 months after survey completion, computerized utilization and cost data were ascertained. RESULTS: Better baseline asthma-specific HRQL was associated with a decreased risk of asthma-related emergency department visit or hospitalization during longitudinal followup (odds ratio per 10-point score increment 0.84; 95% confidence interval [CI] 0.74 to 0.95), controlling for demographic and clinical factors. Better baseline generic physical HRQL was associated with a decreased risk of future all-cause hospitalization (odds ratio 0.68; 95% CI 0.60 to 0.77). More favorable asthma-specific HRQL scores were also related to decreased asthma-related health care costs during the ensuing year (-0.086 log-dollars per 10-point score increment; 95% CI -0.11 to -0.06). Better generic physical HRQL scores were associated with lower total costs (-0.24 log-dollars; 95% CI -0.32 to -0.17). CONCLUSIONS: In a large cohort of adult health maintenance organization members with asthma, asthma-specific HRQL was associated with future asthma-related utilization and cost.
BACKGROUND: Although health-related quality of life (HRQL) has been increasingly used as an outcome in asthma, its utility for identifying patients at risk for adverse asthma outcomes has not been established. OBJECTIVE: In a prospective cohort study, to evaluate the longitudinal impact of HRQL on future health care utilization and cost among adults with asthma, accounting for known risk factors for utilization. METHODS: A stratified random sample of 3,482 adult Northern CA Kaiser Permanente members with asthma was selected using computerized utilization databases and a screening survey item. Subjects completed a mail survey that included measures of generic (SF-12) and asthma-specific HRQL (ITG-Asthma Short Form battery). During the 12 months after survey completion, computerized utilization and cost data were ascertained. RESULTS: Better baseline asthma-specific HRQL was associated with a decreased risk of asthma-related emergency department visit or hospitalization during longitudinal followup (odds ratio per 10-point score increment 0.84; 95% confidence interval [CI] 0.74 to 0.95), controlling for demographic and clinical factors. Better baseline generic physical HRQL was associated with a decreased risk of future all-cause hospitalization (odds ratio 0.68; 95% CI 0.60 to 0.77). More favorable asthma-specific HRQL scores were also related to decreased asthma-related health care costs during the ensuing year (-0.086 log-dollars per 10-point score increment; 95% CI -0.11 to -0.06). Better generic physical HRQL scores were associated with lower total costs (-0.24 log-dollars; 95% CI -0.32 to -0.17). CONCLUSIONS: In a large cohort of adult health maintenance organization members with asthma, asthma-specific HRQL was associated with future asthma-related utilization and cost.
Authors: Sandra R Wilson; Cynthia S Rand; Michael D Cabana; Michael B Foggs; Jill S Halterman; Lynn Olson; William M Vollmer; Rosalind J Wright; Virginia Taggart Journal: J Allergy Clin Immunol Date: 2012-03 Impact factor: 10.793
Authors: Barbara J Polivka; Rodney Folz; John Myers; Russell Barnett; Demetra Antimisiaris; Anna Jorayeva; Bryan Beatty Journal: Res Nurs Health Date: 2018-08 Impact factor: 2.228
Authors: Mario Castro; Adalberto S Rubin; Michel Laviolette; Jussara Fiterman; Marina De Andrade Lima; Pallav L Shah; Elie Fiss; Ronald Olivenstein; Neil C Thomson; Robert M Niven; Ian D Pavord; Michael Simoff; David R Duhamel; Charlene McEvoy; Richard Barbers; Nicolaas H T Ten Hacken; Michael E Wechsler; Mark Holmes; Martin J Phillips; Serpil Erzurum; William Lunn; Elliot Israel; Nizar Jarjour; Monica Kraft; Narinder S Shargill; John Quiring; Scott M Berry; Gerard Cox Journal: Am J Respir Crit Care Med Date: 2009-10-08 Impact factor: 21.405