Presentation (CTI)

OBJECTIVES: Healthcare utilization (HCRU) among patients with asthma in the United States (US) is not well-characterized, and studies generally focus on patients with severe disease. This study assessed HCRU of asthma by disease severity.
METHODS: This study utilized structured and unstructured data from electronic health records (EHR) from three US-based health systems and linked claims data. Patients were included if they had at least 2 encounters indicating asthma between January 1, 2015 and June 30, 2023 and were at least 18 years old at index date. Patients were followed until the first of: last contact, death, disease progression, or study end date (December 31, 2023). Severity was identified using a peer-reviewed, advanced methodology that incorporates unstructured EHR data (DOI: 10.1097/EDE.0000000000001803). Demographics and rates (per 100 person-years [PY]) of asthma-related outpatient care, admissions, and emergency department (ED) visits were determined.
RESULTS: We identified 4,579 patients with mild (3,230 [70%]), moderate (1,048 [23%]), severe (301 [7%]) asthma at index. Patients were predominantly female (67%), white (46%), non-Hispanic (61%), and older than 45 at index (58%). The rate (per 100 PY) of outpatient visits was 40.5 (95% confidence interval [CI], 39.5-41.6), 52.3 (95% CI, 50.4-54.3), and 71.2 (95% CI, 67.4-75.0) for patients with mild, moderate, and severe asthma, respectively. The rate of hospitalizations was 0.4 (95% CI, 0.3-0.5), 1.0 (95% CI, 0.8-1.3), and 3.8 (95% CI, 3.0-4.8). The rate of ED visits was 5.5 (95% CI, 5.1-5.9), 9.7 (95% CI, 8.8-10.5), and 16.7 (95% CI, 14.9-18.6).
CONCLUSIONS: Consistent with studies in non-US patient populations, this study demonstrated that HCRU increased monotonically with greater disease severity. These findings suggest an opportunity to reduce overall HCRU burden through better management of mild and moderate asthma.