Trends and regional distribution of outpatient claims for asthma, 2009–2016, Germany

OBJECTIVE: To investigate asthma morbidity in Germany by calculating current prevalence, examining its temporal and spatial trends and estimating the total number of asthmatics in Germany and calculating age-, sex- and residence-specific risk. METHODS: . We assessed the risk of asthma by sex, age, type of residence (rural versus urban) and federal state (East versus West) using a multilevel parametric survival regression. Living in the western (versus eastern) federal states and living in densely populated large urban municipalities (versus rural area) were independently associated with an increased risk of asthma, with hazard ratios of 1.33 (95% CI: 1.32-1.34) and 1.32 (95% CI: 1.31-1.32), respectively. CONCLUSION: Our insights into the spatial distribution of asthma morbidity may inform public health interventions, including region-specific prevention programmes and control.