Health care resource utilization and characteristics of patients with eosinophilic asthma in secondary health care in Finland

Background: Eosinophilic airway inflammation is common in asthma patients and appears to be associated with severe exacerbations and loss of asthma control. Objective: To describe the resource utilization and clinical characteristics of patients with eosinophilic asthma. Design: Asthma patients >= 18 years with >= 1 blood eosinophil count in secondary care (South West Finland) during 2003. 2013 were included. Clinical characteristics (age, lung function, body mass index, and comorbidities) and asthma-related resource utilization (hospital admissions, outpatient visits, and emergency room [ER] visits) were retrieved. Resource utilization rates were compared for patients with blood eosinophil 300 cells/mu L, using adjusted negative binomial regression models. Results: Overall, 4,357 eligible patients were identified (mean age 60 years, females 68%), of which 1,927 (44%) had > 300 eosinophil cells/mu L blood. Patients with 300 eosinophil counts, exhibited similar clinical characteristics, including advanced age, poor lung function, and overweight. Comorbidities such as pneumonia, sinusitis, and nasal polyps, were more frequent among those with > 300 eosinophil cells/mu L blood compared with patients with lower counts. Eosinophil counts > 300 cells/mu L were associated with greater hospital admissions (rate ratio [RR] [95% confidence interval CI]: 1.13 [1.02; 1.24]) and outpatient visits (RR [95% CI]: 1.11 [1.03; 1.20]) compared with patients with lower eosinophil counts. Rates of ER visits were similar between the patient groups (RR [95% CI]: 0.99 [0.87; 1.12]). Conclusions: Hospital admissions and outpatient visits occurred more often for patients with eosinophil counts > 300 cells/mu L, than for patients with lower eosinophil counts. Routine blood eosinophil screening might be useful to identify patients with an eosinophilic phenotype eligible for more targeted treatments.Peer reviewe