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Asthma-related health care resource use among asthmatic children with and without concomitant allergic rhinitis Asthma and allergic rhinitis are both common childhood illnesses that place a substantial burden on health care systems. At least 20% of children are affected by asthma in the United Kingdom, (1) which has one of the highest prevalences of childhood asthma worldwide. (2) Much of the data relating to the health care burden applies to the United States, where the prevalence of current childhood asthma is 8.7%. (3) Each year in the United States, asthma is responsible for 6.5 office or clinic visits, 1.0 emergency department (ED) visit, and 0.30 hospitalizations per 100 children. (3) Emergency care (ED visits or hospitalization) for childhood asthma is relatively infrequent but consumes a disproportionate percentage of expenditures: 62% of expenditures on childhood asthma nationwide and from 37% to >50% of health care expenditures for childhood asthma in studies of US managed care data systems. (4-6) Childhood allergic rhinitis is also highly prevalent; the worldwide prevalence ranges up to ~40% in 13-to 14-year-olds. (7) When viewed in isolation, allergic rhinitis is not associated with significant emergency care costs. In the United States, ED visits represent only ~1% of the direct medical costs of allergic rhinitis. (8,9) Allergic rhinitis and asthma are linked epidemiologically and therapeutically, and it is theorized that both conditions are manifestations of a single inflammatory process in the airways. (10,11) In populationbased studies conducted in the United States, ~50% of children with allergic rhinitis also had asthma, (12) and ~50% of children with asthma also had allergic rhinitis. (13) Some medications, such as corticosteroids and antileukotrienes, are effective against both conditions. (10) There is, however, little information about medical resource use by children with both asthma and allergic rhinitis or of the impact of comorbid allergic rhinitis on the use of emergency and other health care services related to asthma. The objective of this study was to determine the direct medical burden of comorbid allergic rhinitis and asthma compared with that of asthma alone.

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