School absence and productivity outcomes associated with childhood asthma in the USA

Background: Previous studies have examined the association between childhood asthma and lost productivity; however, more data are needed to understand its impact. Methods: This was a retrospective analysis of cross-sectional data in the nationally representative 2007–2013 Medical Expenditure Panel Survey (MEPS). School-aged children (SAC), children (age 6–11), and adolescents (age 12–17) with asthma were compared to those without asthma to examine annual missed school days. Adult parents/caregivers of SAC with asthma were compared to those of SAC without asthma to examine missed work days. The cost of premature asthma mortality for SAC was also estimated. Negative binomial regression was used for missed school days, and a two-part model structure was used for missed work days. All analyses controlled for sociodemographics and other covariates. Results: There were 44,320 SAC of whom 5,890 had asthma. There were 43,496 employed adults with at least one child. SAC (6–17) with asthma missed 1.54 times the number of school days compared to SAC without asthma. Caregivers of SAC (6–17) with asthma missed 1.16 times the number of work days to care for others compared to caregivers of SAC without asthma. SAC in the USA missed an additional 7 million school days associated with asthma (3.7 million children and 3.3 million adolescent). There were 130 asthma deaths resulting in an annual cost of $211 million ($US 2015). Conclusions: Childhood asthma is associated with a significant school absence and productivity loss in the USA. Better treatment and asthma management programs are needed to alleviate this burden.