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ICD Code: 493. Asthma



ICD Code: 493. Article Review
Title: Akinbami LJ et al; "Asthma Prevalence, Health Care Use, and Mortality: United States, 2005-2009." National Health Statistics Report; No.32; 1/12/11; p1
      STUDY DESIGN: Estimates in this study for asthma prevalence, school and work absences, and asthma control measures are based on data from the National Health Interview Survey (NHIS). NHIS serves as a principal source of health information for the U.S. civilian noninstitutionalized population. In 2008, an asthma supplement ascertained aspects of disease control and asthma-specific absences from school and work (questionnaires for 2008 and other years can be viewed at: http://www.cdc.gov/nchs/nhis/nhis_questionnaires.htm). Ambulatory visit numbers and rates were estimated using data from the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS). Data for asthma hospitalization numbers and rates were obtained from the National Hospital Discharge Survey (NHDS). Asthma death data were obtained from the National Vital Statistics System (NVSS).
      PREVALENCE TRENDS: Total current asthma prevalence in 2009 was 8.2% and was reported as follows for selected variables: male, 7.0%; female, 9.3%; ages 0-17 years, 9.6%; ages 18 and older, 7.7%; white, 7.8%; black, 11.1%; American Indian or Alaska Native, 8.8%; Asian, 5.3%; Non-Hispanic white, 8.2%; Non-Hispanic black, 11.1%; Total Hispanic, 6.3%; Puerto Rican, 16.6%; Mexican, 4.9%; below poverty, 11.6%; 100% to less than 200% poverty, 8.5%; 200% poverty and above, 7.3%; metropolitan, 8.1%; nonmetropolitan, 8.7%; northeast, 9.3%; midwest, 8.8%; south, 7.5%; west, 7.7%. The current asthma period prevalence was reported as follows for selected years: 2001, 7.4%; 2002, 7.2%; 2003, 7.0%; 2004, 7.1%; 2005, 7.6%; 2006, 7.8%; 2007, 7.7%; 2008, 7.8%; 2009, 8.2%.
      In 2009, current asthma prevalence was 8.2%, affecting 24.6 million people in the United States (17.5 million adults and 7.1 million children aged 0-17 years). Asthma attack prevalence (the proportion of the population with at least one attack in the previous year) was 4.2%. That is, 12.8 million people (8.7 million adults and 4.0 million children aged 0-17 years), or 52% of those with current asthma, had attacks and were at risk for adverse outcomes such as emergency department (ED) visits or hospitalization. The most rapid growth in asthma prevalence occurred from 1980 to 1996, when asthma period prevalence grew from 3.5% to 5.5%, an annual percentage increase of 3.8%. In 1997, survey measures changed to capture more detailed aspects of asthma prevalence, and estimates before and after the change cannot be directly compared. The measure most comparable to the pre-1997 asthma period prevalence estimate is current asthma prevalence, which had remained stable (at 7.4%) since it first became available in 2001 but recently began increasing so that overall, the annual percentage increase from 2001 to 2009 was 1.2%. Asthma attack prevalence remained level between 3.9% and 4.3% during 1997-2009.
      Overall, females have higher current asthma prevalence than males, although among children aged 0-17 years, boys have a higher prevalence (11.3%) than girls (7.9%). Children have higher current asthma prevalence than adults. Compared with white persons, prevalence is higher among black and lower among Asian persons.
      HEALTH CARE UTILIZATION: In 2007, 13.9 million visits for asthma were made to private physician offices (7.2 million for adults and 6.7 million for children aged 0-17 years) and 1.4 million visits to hospital outpatient departments (OPDs) (0.6 million for adults and 0.8 million for children aged 0-17 years). There were 1.75 million ED visits (1.11 million for adults and 0.64 million for children aged 0-17 years) and 456,000 asthma hospitalizations (299,000 for adults and 157,000 for children aged 0-17 years).
      MORTALITY: The number of deaths per 10,000 persons with asthma was reported as follows: total, 1.6; male, 1.4; female, 1.8; white, 1.4; black, 2.7; Hispanic, 0.9; non-Hispanic, 1.7; under age 18 years, 0.3; age 18 years and over, 2.1. There were 3447 deaths due to asthma in 2007 (3262 among adults and 185 among children aged 0-17 years).
      CLINICAL MANAGEMENT: The cornerstone of clinical guidelines for the management of asthma is control of symptoms and prevention of adverse outcomes. In 2008, about 96% of people with current asthma reported that a health professional taught them how to use their inhaler, nearly meeting the Healthy People 2010 target of 98.8%. However, 34% reported receiving an asthma management plan with specific instructions on how to change the amount or type of medicine taken, when to call a doctor for advice, and when to go to the ED, and 60% reported that they were taught how to recognize early signs and symptoms of an asthma episode. Report of receiving these asthma control strategies differed among groups, with generally higher rates among children than adults and among non-Hispanic black persons than non-Hispanic white and Mexican persons.
      DISCUSSION: Although increases in asthma prevalence have slowed since the mid-1990s, asthma prevalence remains at historically high levels. Current asthma prevalence differs between groups, with higher rates among females, children, non-Hispanic black and Puerto Rican persons, those with family income below the poverty level, and those residing in the Northeast and Midwest regions.

Search Criteria: Text - National Health Statistics Report; No.32; 1/12/11; p1