Integrated traditional Chinese medicine for childhood asthma in Taiwan: a Nationwide cohort study

BACKGROUND Traditional Chinese medicine (TCM) is the most commonly used alternative therapy in children with asthma, especially in the Chinese community. This study aimed to investigate the effects of the government-sponsored Outpatient's Healthcare Quality Improvement (OHQI) project with integrated TCM treatment on childhood asthma. METHODS This study used the Longitudinal Health Insurance Database 2000, which is a part of the Taiwan National Health Insurance Research Database (NHIRD). Children with diagnosed asthma and aged under 15 years from 2006-2010 were enrolled. They were collated into 3 groups: (1) subjects treated with non-TCM; (2) subjects treated with single TCM; and (3) subjects treated with integrative OHQI TCM. The medical visits and the cost of treatment paid by the Bureau of National Health Insurance (BNHI) to the outpatient, emergency room, and inpatient departments were evaluated for the study subjects within 1 year of the first asthma diagnosis during the study period. RESULTS Fifteen multi-hospitals, including 7 medical centers, and 35 TCM physicians participated in OHQI during the study period. A total of 12850 children from the NHIRD database were enrolled in this study, and divided as follows: 12435 children in non-TCM group, 406 children in single TCM group, and 9 children in integrative OHQI TCM group. Although the total medical cost paid by the BNHI per patient in the integrative OHQI TCM group was greater than that in the non-OHQI groups, the patients in the integrative OHQI TCM group exhibited greater therapeutic effects, and did not require ER visits or hospitalization. In addition, ER visits and hospitalization among patients who received a combination of conventional therapy with integrated TCM were lower than those among patients who underwent conventional therapy alone or single TCM treatment. CONCLUSIONS Asthmatic children at partly controlled level under conventional therapy may benefit from adjuvant treatment with integrated TCM.