OBJECTIVE: We sought to understand if pediatrician characteristics and asthma assessment and treatment varied in association with the proportion of African-American and Latino children in the pediatrician's practice. METHODS: We conducted a cross-sectional survey of 500 American Academy of Pediatrics members between November 2005 and May 2006. Standardized vignettes were used to test how different indicators of a patient's asthma status affect pediatrician asthma assessments and recommendations. Linear and logistic regression models were used to examine the association of pediatrician assessments and treatment recommendations for these vignettes, respectively, with the proportion of reported African-American and Latino children seen in their practice. RESULTS: There were 270 respondents (response rate = 54%). Based on pediatrician-reported percentage of minority patients, there were no differences in board certification status, recognition of poorly controlled asthma nor in the likelihood of appropriately increasing long-term controller medications to treat poorly controlled asthma (p > 0.05 for all analyses). CONCLUSIONS: Caring primarily for minority children by AAP pediatricians appears unrelated to training qualifications or in their reported knowledge of how to appropriately assess and treat asthma. Therefore, studies of asthma care disparities should focus on understanding the knowledge-base of non-AAP pediatric providers who care for minority populations and exploring other potential contributory provider-level factors (e.g. communication skills).
OBJECTIVE: We sought to understand if pediatrician characteristics and asthma assessment and treatment varied in association with the proportion of African-American and Latino children in the pediatrician's practice. METHODS: We conducted a cross-sectional survey of 500 American Academy of Pediatrics members between November 2005 and May 2006. Standardized vignettes were used to test how different indicators of a patient's asthma status affect pediatrician asthma assessments and recommendations. Linear and logistic regression models were used to examine the association of pediatrician assessments and treatment recommendations for these vignettes, respectively, with the proportion of reported African-American and Latino children seen in their practice. RESULTS: There were 270 respondents (response rate = 54%). Based on pediatrician-reported percentage of minority patients, there were no differences in board certification status, recognition of poorly controlled asthma nor in the likelihood of appropriately increasing long-term controller medications to treat poorly controlled asthma (p > 0.05 for all analyses). CONCLUSIONS: Caring primarily for minority children by AAP pediatricians appears unrelated to training qualifications or in their reported knowledge of how to appropriately assess and treat asthma. Therefore, studies of asthma care disparities should focus on understanding the knowledge-base of non-AAP pediatric providers who care for minority populations and exploring other potential contributory provider-level factors (e.g. communication skills).
Authors: Michael D Cabana; Kathryn K Slish; David Evans; Robert B Mellins; Randall W Brown; Xihong Lin; Niko Kaciroti; Noreen M Clark Journal: Pediatrics Date: 2006-06 Impact factor: 7.124
Authors: K A Schulman; J A Berlin; W Harless; J F Kerner; S Sistrunk; B J Gersh; R Dubé; C K Taleghani; J E Burke; S Williams; J M Eisenberg; J J Escarce Journal: N Engl J Med Date: 1999-02-25 Impact factor: 91.245
Authors: Gregory B Diette; Cecilia M Patino; Barry Merriman; Laura Paulin; Kristin Riekert; Sande Okelo; Kathy Thompson; Jerry A Krishnan; Ruth Quartey; Deanna Perez-Williams; Cynthia Rand Journal: Arch Intern Med Date: 2007-07-09
Authors: John W Peabody; Jeff Luck; Peter Glassman; Sharad Jain; Joyce Hansen; Maureen Spell; Martin Lee Journal: Ann Intern Med Date: 2004-11-16 Impact factor: 25.391