Allergy Asthma Immunol Res.  2020 May;12(3):467-484. 10.4168/aair.2020.12.3.467.

Increasing Prevalence and Mortality of Asthma With Age in Korea, 2002–2015: A Nationwide, Population-Based Study

• Lee E
• Kim A
• Ye YM
• Choi SE
• Park HS

• KMID: 2471230
• DOI: http://doi.org/10.4168/aair.2020.12.3.467

Abstract

PURPOSE
The prevalence of asthma is increasing globally as the world population increases; however, and the prevalence and mortality of asthma have not been extensively investigated. Also, the effects of severity and aging on asthma prevalence and mortality are unknown. We aimed to investigate trends of the prevalence and mortality of asthma as well as health care uses and costs over 14 years according to disease severity by using real-world data in Korea.
METHODS
Using the National Health Insurance Sharing Service database, we extracted asthmatic patients having diagnosis codes of asthma and prescription records of antiasthmatic medications from 2002 to 2015 and categorized them according to asthma exacerbation and regular treatment. We defined asthma-associated death in terms of patients' prescription records within 3 months before all-cause death, then linked with the Cause of Death Statistics. The annual asthma-related health care uses and costs were analyzed.
RESULTS
The prevalence rates of asthma (1.6% to 2.2%) and severe asthma (SA; 3.5% to 6.1% among total asthmatics) have increased steadily over the decade in Korea, where the proportion of elderly asthmatics having increased. The asthma-related health care uses and costs had increased during the study period with the highest uses/costs in SA. The asthma mortality had a steady rising trend from 16.2 to 28.0 deaths per 100,000 with the highest mortality in SA.
CONCLUSIONS
The prevalence and mortality of asthma as well as SA increases along with the burden of health care uses/costs. More active interventions, including changes in health care policies, are needed to reduce the prevalence and mortality of asthma, especially SA.

Keyword

Asthma; prevalence; mortality; health care costs; morbidity; aged

MeSH Terms

Aged
Aging
Asthma*
Cause of Death
Delivery of Health Care
Diagnosis
Health Care Costs
Humans
Korea*
Mortality*
National Health Programs
Prescriptions
Prevalence*

Figure

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  Fig. 1 (A) Age-standardized prevalence of asthma (over 12 years) in Korea. (B) Prevalence of asthma by age groups.

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  Fig. 2 (A) Percentage of UCT by sex. (B) Percentage of asthma groups. (C) Percentage of SA group and UCT by age groups.SA, severe asthma; UT, untreated asthma; WC, well-controlled asthma; IT, intermittently treated asthma; UCT, uncontrolled asthmatics.

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  Fig. 3 Trends in the percentage of prescribed medications in (A) uncontrolled asthmatics and (B) the severe asthma group. The proportion of (C) uncontrolled asthmatics and (D) the severe asthma group according to treatment steps.SABA, short-acting β2-agonist; SAMA, short-acting muscarinic antagonist; LTRA, leukotriene receptor antagonist; ICS, inhaled corticosteroids; LABA, long-acting β2-agonist; PO, by mouth.

• 

  Fig. 4 (A) Asthma mortality rates, AAD, and ACTD, compared to those from Statistics Korea. (B) Trends of asthma-associated mortality rates per 100,000 in males and females. (C) Asthma-associated mortality rates per 100,000 by asthma groups.AAD, asthma-associated deaths; ACTD, asthma-contributing deaths; AS-AAD, age-standardized asthma-associated deaths; SA, severe asthma; UT, untreated asthma; WC, well-controlled asthma; IT, intermittently treated asthma.

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  Fig. 5 The percentage of healthcare use in (A) outpatient and (B) inpatient care.

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  Fig. 6 (A) Total asthma-related costs. (B) Inpatient medical costs by age groups.

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