Patterns of hospitalization and healthcare utilization across attitudinal clusters: analysis from patient survey in Asia

Abstract

BACKGROUND/AIM: Uncontrolled asthma is associated with higher utilization rates of healthcare services. REALISE, a recent survey in Europe has shown how patient attitudes towards asthma and its treatment impact on resource utilization. We present here the findings from a similar survey in 8 countries in Asia, focusing on hospitalization patterns in patients across the identified attitudinal clusters. METHODS: Previously reported analysis identified 5 attitudinal clusters from a multi-country online survey of 2,467 adult patients with asthma (age 18–50 years, ≥2 prescriptions for asthma in past two years). The 5 clusters are: 1. ‘Well-adjusted’ – high asthma control and most confident in managing it; 2. ‘Rejector’ – high control but refuse to accept the asthma label; 3. ‘Lost’ – low control and most socially conscious about asthma; 4. ‘Endurers’ – low control with low level of confidence in managing asthma, and; 5. ‘Worriers’ lowest control and high level of concern about their asthma. RESULTS: Cluster 1 had the highest proportion of patients who had not experienced asthma exacerbations in the past 12 months. Clusters 1 and 2 had the least proportion of emergency room visits for asthma (17% and 27% respectively), compared to the Clusters 3, 4, and 5 (58%, 47%, and 63% respectively). The same pattern is seen for overnight hospitalization as a result of asthma: 12%, 16%, 55%, 42%, and 62% for Clusters 1, 2, 3, 4, and 5 respectively. Mean number of times that patients in Cluster 5 were given antibiotics in the past 12 months because of asthma was 3.5x, compared to only 1.2x and 1.6x for those in Clusters 1 and 2. CONCLUSION: The five attitudinal clusters have differing rates of hospitalization and health care utilization, which appears to be reflective of their level of control and attitudes towards their disease. Such insight can help health care professionals tailor a management approach for patients included in each of the clusters.