BACKGROUND: Significant disparities in emergency department (ED) rates exist for Latinos; however, few studies have investigated the factors that may account for these disparities. OBJECTIVES: To examine individual/family and health system factors among Latino and non-Latino white (NLW) children with asthma to explain disparities in ED rates. METHODS: The study was carried out in Puerto Rico (PR) and Rhode Island (RI) with the same design: a cross-sectional, observational approach with repeated measurements of selected variables. RESULTS: The sample was composed of 804 children ages 7 to 15 years, with 405 from PR and 399 from RI. Latino children from both sites had significantly higher rates of ED use as compared with NLWs from RI. Regression analyses showed site, asthma control, parental reported severity of asthma and public insurance to be significantly associated with ED use. CONCLUSION: Latino ethnicity and public insurance were among the most important factors related to frequent ED use. Revisions of the policies driving public insurance to assure better access to specialists, preventive education, and evidence-based treatment are needed. The results also suggest the need for the development of interventions in the ED that are geared toward educating families on how best to use emergency services.
BACKGROUND: Significant disparities in emergency department (ED) rates exist for Latinos; however, few studies have investigated the factors that may account for these disparities. OBJECTIVES: To examine individual/family and health system factors among Latino and non-Latino white (NLW) children with asthma to explain disparities in ED rates. METHODS: The study was carried out in Puerto Rico (PR) and Rhode Island (RI) with the same design: a cross-sectional, observational approach with repeated measurements of selected variables. RESULTS: The sample was composed of 804 children ages 7 to 15 years, with 405 from PR and 399 from RI. Latino children from both sites had significantly higher rates of ED use as compared with NLWs from RI. Regression analyses showed site, asthma control, parental reported severity of asthma and public insurance to be significantly associated with ED use. CONCLUSION: Latino ethnicity and public insurance were among the most important factors related to frequent ED use. Revisions of the policies driving public insurance to assure better access to specialists, preventive education, and evidence-based treatment are needed. The results also suggest the need for the development of interventions in the ED that are geared toward educating families on how best to use emergency services.
Authors: Gregory K Fritz; Elizabeth L McQuaid; Sheryl J Kopel; Ronald Seifer; Robert B Klein; Daphne Koinis Mitchell; Cynthia A Esteban; Jose Rodriguez-Santana; Angel Colon; Maria Alvarez; Glorisa Canino Journal: Am J Respir Crit Care Med Date: 2010-03-18 Impact factor: 21.405
Authors: Doryliz Vila; Cynthia S Rand; Michael D Cabana; Amarilis Quiñones; Mirla Otero; Christina Gamache; Rafael Ramírez; Pedro García; Glorisa Canino Journal: J Asthma Date: 2010-11-01 Impact factor: 2.515
Authors: Barbara Jandasek; Alexander N Ortega; Elizabeth L McQuaid; Daphne Koinis-Mitchell; Gregory K Fritz; Sheryl J Kopel; Ronald Seifer; Robert B Klein; Glorisa Canino Journal: Med Care Res Rev Date: 2011-05-02 Impact factor: 3.929
Authors: Cynthia A Esteban; Robert B Klein; Elizabeth L McQuaid; Gregory K Fritz; Ronald Seifer; Sheryl J Kopel; Jose Rodriguez Santana; Angel Colon; Maria Alvarez; Daphne Koinis-Mitchell; Alexander N Ortega; Brenda Martinez-Nieves; Glorisa Canino Journal: J Allergy Clin Immunol Date: 2009-07-16 Impact factor: 10.793
Authors: Glorisa Canino; Elizabeth L McQuaid; Maria Alvarez; Angel Colon; Cynthia Esteban; Vivian Febo; Robert B Klein; Daphne Koinis Mitchell; Sheryl J Kopel; Federico Montealegre; Alexander N Ortega; Jose Rodriguez-Santana; Ronald Seifer; Gregory K Fritz Journal: Pediatr Pulmonol Date: 2009-09
Authors: Sande O Okelo; Michelle N Eakin; Cecilia M Patino; Alvin P Teodoro; Andrew L Bilderback; Darcy A Thompson; Antonio Loiaza-Martinez; Cynthia S Rand; Shannon Thyne; Gregory B Diette; Kristin A Riekert Journal: J Allergy Clin Immunol Date: 2013-02-21 Impact factor: 10.793
Authors: Daphne Koinis-Mitchell; Sheryl J Kopel; Julie Boergers; Elizabeth L McQuaid; Cynthia A Esteban; Ronald Seifer; Gregory K Fritz; Alvaro J Beltran; Robert B Klein; Monique LeBourgeois Journal: J Pediatr Psychol Date: 2015-05-18
Authors: Sarah R Martin; Julie Boergers; Sheryl J Kopel; Elizabeth L McQuaid; Ronald Seifer; Monique LeBourgeois; Robert B Klein; Cynthia A Esteban; Gregory K Fritz; Daphne Koinis-Mitchell Journal: J Pediatr Psychol Date: 2017-09-01
Authors: Robin S Everhart; Samantha A Miadich; Gillian G Leibach; Adrienne P Borschuk; Daphne Koinis-Mitchell Journal: J Asthma Date: 2016-04-26 Impact factor: 2.515
Authors: Sara E Grineski; Timothy W Collins; Paola Chavez-Payan; Anthony M Jimenez; Stephanie Clark-Reyna; Marie Gaines; Young-an Kim Journal: Int J Environ Res Public Health Date: 2014-03-11 Impact factor: 3.390