DRAFT Alameda County Asthma Related Cost Maps
DRAFT Alameda County Asthma Related Cost Maps
DRAFT Alameda County Asthma Related Cost Maps
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Estimating disparities<br />
in the cost of asthma<br />
in <strong>Alameda</strong> <strong>County</strong><br />
<strong>Asthma</strong>-related health events<br />
Each health “event” related to asthma is<br />
distributed differently throughout the county<br />
Eric M. Roberts, MD PhD<br />
Geoff Lomax, DrPH<br />
Mortality<br />
Outpatient visits<br />
Makinde Falade, MS-GIS<br />
Lucia Somberg<br />
Hospitalizations<br />
Symptom<br />
medication Maintenance<br />
Environmental Health Investigations Branch<br />
Division of Environmental and Occupational Disease Control<br />
California Department of Health Services<br />
ER visits<br />
purchasing medication<br />
purchasing<br />
2<br />
<strong>Asthma</strong>-related health events<br />
Each health “event” related to asthma is<br />
distributed differently throughout the county<br />
ER visits<br />
Maintenance<br />
medication<br />
purchasing<br />
<strong>Asthma</strong>-related health events<br />
• At any given point, we can calculate a rate for<br />
hospitalizations, ER visits, outpatient visits,<br />
and medication purchases using these maps<br />
• The total cost due to asthma is the sum of the<br />
costs of all of these events<br />
3<br />
5<br />
<strong>Asthma</strong>-related health events<br />
• Hospitalizations and ER visits are much<br />
more expensive than clinic visits and<br />
medications<br />
• Does this mean that the spending on<br />
asthma (per child) is different for<br />
locations across the county?<br />
Where did we find the cost<br />
information for each event?<br />
• The Medical Expenditure Panel Survey<br />
(MEPS) is administered nationally each year,<br />
mostly for economic analysis of health care<br />
• This source is not perfect:<br />
– MEPS numbers don’t say how much the event<br />
costs in <strong>Alameda</strong> <strong>County</strong>, but rather how much it<br />
costs, on average, in the US<br />
– For some numbers, we can get estimates for the<br />
western US, but for others we can’t<br />
– For some estimates the methods (for example, of<br />
how you define asthma) are a little funky<br />
4<br />
6<br />
1
MEPS estimates for asthma<br />
event costs<br />
<strong>Asthma</strong>-related event<br />
Hospitalization<br />
Emergency Room visit<br />
Outpatient visit<br />
Symptom medication purchase<br />
Maintenance medication<br />
purchase<br />
Average total cost ($)<br />
7029<br />
284<br />
64<br />
34<br />
76<br />
NOTE: The confidence intervals on these cost estimates are<br />
really big<br />
<strong>Asthma</strong>-related cost per capita<br />
<strong>Alameda</strong> <strong>County</strong>, 2001<br />
7<br />
9<br />
Limitations to remember<br />
• The confidence intervals on these cost<br />
estimates are really big<br />
• The rates of asthma-related events are<br />
calculated from our non-representative<br />
sample…<br />
– The variations across the map are likely to<br />
be real<br />
– The absolute numbers shown in the map<br />
are likely to be off<br />
8<br />
2