Jeanette A Stingone1, Luz Claudio. 1. Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, New York 10029-6574, USA.
Abstract
BACKGROUND: Urgent care composes one third of the total costs associated with asthma. Asthmatic children of African American and Latino backgrounds have higher rates of emergency department (ED) use and hospitalizations than white children, especially in urban settings. OBJECTIVE: To evaluate the role of socioeconomic, disease-related, and access-to-care factors in utilization of the ED and inpatient services for urgent treatment of asthma. METHODS: A parent-response questionnaire was systematically distributed in public elementary schools that serve children of different socioeconomic backgrounds in New York City. RESULTS: The prevalence of current asthma was found to be 13.0% in 5- to 12-year-old children. Almost half of the current asthmatic patients had used urgent care in the ED or hospital in the previous 12 months. In univariate analysis, use of urgent care was strongly associated with race/ethnicity and income (P < .001). Adjusting for socioeconomic, disease-related, and access-to-care factors, including household income, symptom severity, type of health insurance, and usual source of asthma care, the racial/ethnic disparity persisted, with Latinos having 5 times the risk and African Americans having double the risk of using urgent care as whites. CONCLUSIONS: There is a failure in asthma management in this urban population, demonstrated by the finding that almost half of all current asthmatic patients used urgent care. After controlling for different socioeconomic and disease-related factors, minority race/ethnicity, low household income, and frequent evening symptoms were found to be strong predictors of urgent care utilization. Insurance status, delaying care for any reason, and use of controller medications were found not to be associated with urgent care use.
BACKGROUND: Urgent care composes one third of the total costs associated with asthma. Asthmatic children of African American and Latino backgrounds have higher rates of emergency department (ED) use and hospitalizations than white children, especially in urban settings. OBJECTIVE: To evaluate the role of socioeconomic, disease-related, and access-to-care factors in utilization of the ED and inpatient services for urgent treatment of asthma. METHODS: A parent-response questionnaire was systematically distributed in public elementary schools that serve children of different socioeconomic backgrounds in New York City. RESULTS: The prevalence of current asthma was found to be 13.0% in 5- to 12-year-old children. Almost half of the current asthmatic patients had used urgent care in the ED or hospital in the previous 12 months. In univariate analysis, use of urgent care was strongly associated with race/ethnicity and income (P < .001). Adjusting for socioeconomic, disease-related, and access-to-care factors, including household income, symptom severity, type of health insurance, and usual source of asthma care, the racial/ethnic disparity persisted, with Latinos having 5 times the risk and African Americans having double the risk of using urgent care as whites. CONCLUSIONS: There is a failure in asthma management in this urban population, demonstrated by the finding that almost half of all current asthmatic patients used urgent care. After controlling for different socioeconomic and disease-related factors, minority race/ethnicity, low household income, and frequent evening symptoms were found to be strong predictors of urgent care utilization. Insurance status, delaying care for any reason, and use of controller medications were found not to be associated with urgent care use.
Authors: LaRita C Jones; Sylvie Mrug; Marc N Elliott; Sara L Toomey; Susan Tortolero; Mark A Schuster Journal: Acad Pediatr Date: 2017-02-12 Impact factor: 3.107
Authors: Christian Rosas-Salazar; Sima K Ramratnam; John M Brehm; Yueh-Ying Han; Edna Acosta-Pérez; María Alvarez; Angel Colón-Semidey; Glorisa Canino; Andrea J Apter; Juan C Celedón Journal: Chest Date: 2013-07 Impact factor: 9.410