Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Wednesday, July 01, 2020 at 8:00 PM to 10:00 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?


Previously submitted to: JMIR Medical Informatics (no longer under consideration since Apr 15, 2020)

Date Submitted: Jan 11, 2020
Open Peer Review Period: Jan 11, 2020 - Mar 7, 2020
(closed for review but you can still tweet)

NOTE: This is an unreviewed Preprint

Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note "no longer under consideration" will appear above).

Peer-review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a "Peer-Review Me" button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.

Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).

Final version: If our system detects a final peer-reviewed "version of record" (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.

Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.

Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

The Economic Burden of Medical Treatment of Children with Asthma in China: Real-World Evidence from the Chinese Medical Insurance Database Network

  • Ping Wu; 
  • Baoping Xu; 
  • Adong Shen; 
  • Zonglin He; 
  • Casper J.P. Zhang; 
  • Wai-Kit Ming; 
  • Kunling Shen; 



The incidence of asthma has been increasing worldwide, leading to an increase in its global burden. But there are few studies on the economic burden of children with asthma in China.


To investigate the economic burden of medical treatment of children with asthma in China.


The China Medical Insurance Research Association (CHIRA) database was searched for patients with asthma from 0 to 14 years old who were diagnosed based on the criteria of “J45” and “J46” coded in ICD-10. A cross-sectional study with cost analysis was conducted.


The annual per capita direct medical cost related to all causes of medical visits was RMB$ 2,889 (US$411), and of that, RMB $525 (US$75) was related to asthma. The percentages of medical cost covered by insurance for all causes and asthma in China were 67% and 58%, respectively. The cost of medication accounted for the highest percentage of direct medical costs. The cost of asthma medication accounted for the highest percentage of all medication costs, followed by the cost of antibiotics. The rate of using antibiotics during asthma attack was 50.3%. In each subgroup, the highest rates of using antibiotics were central region of China (100.0%), children aged 3 years and under (63.6%), and fourth-tier and fifth-tier cities (77.1%). Patients were tested by pulmonary function test (12.2%), and allergen test (5.8%) during treatment. Outpatient clinics(98.58% vs 1.42%, P <.01), advanced hospitals (62.08% vs 37.92%, P <.01), and general hospitals (72.27% vs 27.73%, P <.01) were more often visited than the inpatient clinics, mid-level and primary as well as the specialized clinics, respectively.


The economic burden of childhood asthma in China is relatively high, but the national medical insurance reduces their economic burden to a large extent. Based on our findings, there remains opportunities to strengthen the hierarchical medical system, and the Global Initiative for Asthma (GINA) program and Chinese guidelines still need to be further popularized in order to achieve complete control of asthma, thereby reducing hospitalization and emergency visits, shortening hospitalization time, and ultimately reducing the economic burden of children with asthma.


Please cite as:

Wu P, Xu B, Shen A, He Z, Zhang CJ, Ming W, Shen K

The Economic Burden of Medical Treatment of Children with Asthma in China: Real-World Evidence from the Chinese Medical Insurance Database Network

JMIR Preprints. 11/01/2020:17773

DOI: 10.2196/preprints.17773


The author of this paper has made a PDF available, but requires the user to login, or create an account.

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.