Introduction/Background

Severe asthma comprises 5% of asthma burden but >50% of asthma resource expenditure. Comprehensive understanding of how health systems manage severe asthma is needed to identify best practices for improving care.

Methods

Data from 29 OECD countries were collected and a Steering Committee of 6 asthma and health policy experts validated data and led decision-making; funding was provided by Sanofi and Regeneron. 28 indicators impacting the ability of country health systems to manage/prevent severe asthma, were identified and grouped into 5 categories. Final Index scores were normalized and weighted for each indicator category, with Australia ranking 1st overall.

Results

The overall average Index score for all countries was 62/100. The scores for each of categories ranged: Policy Context (20-90), Access Care and Coverage (46-86), Health System Characteristics (44-71), Disease Burden (51-82) and Environmental Factors (60-82). Overall, the index finds the following can be done to improve the 5 categories: definition and implementation of severe asthma strategies; improvements in healthcare system structures and systemic inequalities; improvement of data collection and coding; improve behavioral factors that impact asthma severity; and improvement indoor and outdoor air quality.

Conclusions

As a first-of-its-kind tool, SAI assessed countries? health system approaches to managing severe asthma and other factors that may impact asthma severity and control. These findings emphasize severe asthma remains an inadequately prioritized condition globally and highlight the need for a comprehensive, ?whole system? approach for improved management.