Alexander H Fischer1, Daniel B Shin2, David J Margolis3, Junko Takeshita4. 1. Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland. 2. Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvannia. 3. Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvannia; Department of Biostatistics Epidemiology and Informatics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvannia. 4. Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvannia; Department of Biostatistics Epidemiology and Informatics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvannia. Electronic address: junko.takeshita@uphs.upenn.edu.
Abstract
BACKGROUND: Eczema is a common chronic inflammatory disease of the skin. Studies suggest differences in disease prevalence and severity by race/ethnicity. Our knowledge of health care utilization for eczema among different racial/ethnic groups remains limited. OBJECTIVE: To evaluate health care utilization for childhood eczema among different racial/ethnic groups in the United States. METHODS: We performed a cohort study of non-Hispanic white (reference), non-Hispanic black, and Hispanic white individuals under the age of 18 years with caregiver-reported eczema (N = 2043) pooled from the 2-year longitudinal cohorts of the 2001-2013 Medical Expenditure Panel Surveys. Health care utilization outcomes were evaluated over the 2-year follow-up period by race/ethnicity using multivariable regression. RESULTS: Among all children with eczema, non-Hispanic blacks were less likely than whites to report an ambulatory visit for eczema (adjusted odds ratio [ORadj] 0.69; 95% confidence interval [CI] 0.51-0.92). Among those with ≥1 ambulatory visit for eczema, non-Hispanic blacks reported more visits (adjusted incidence rate ratio [IRRadj] 1.68; 95% CI 1.10-2.55) and prescriptions (IRRadj 1.22; 95% CI 1.01-1.46) than whites and were more likely than whites to report a dermatology visit (ORadj 1.82; 95% CI 1.06-3.14) for eczema. LIMITATIONS: We used caregiver- or self-reported data. CONCLUSION: Our findings suggest disparities in health care utilization for eczema among non-Hispanic black children despite utilization patterns suggestive of more severe disease.
BACKGROUND:Eczema is a common chronic inflammatory disease of the skin. Studies suggest differences in disease prevalence and severity by race/ethnicity. Our knowledge of health care utilization for eczema among different racial/ethnic groups remains limited. OBJECTIVE: To evaluate health care utilization for childhood eczema among different racial/ethnic groups in the United States. METHODS: We performed a cohort study of non-Hispanic white (reference), non-Hispanic black, and Hispanic white individuals under the age of 18 years with caregiver-reported eczema (N = 2043) pooled from the 2-year longitudinal cohorts of the 2001-2013 Medical Expenditure Panel Surveys. Health care utilization outcomes were evaluated over the 2-year follow-up period by race/ethnicity using multivariable regression. RESULTS: Among all children with eczema, non-Hispanic blacks were less likely than whites to report an ambulatory visit for eczema (adjusted odds ratio [ORadj] 0.69; 95% confidence interval [CI] 0.51-0.92). Among those with ≥1 ambulatory visit for eczema, non-Hispanic blacks reported more visits (adjusted incidence rate ratio [IRRadj] 1.68; 95% CI 1.10-2.55) and prescriptions (IRRadj 1.22; 95% CI 1.01-1.46) than whites and were more likely than whites to report a dermatology visit (ORadj 1.82; 95% CI 1.06-3.14) for eczema. LIMITATIONS: We used caregiver- or self-reported data. CONCLUSION: Our findings suggest disparities in health care utilization for eczema among non-Hispanic black children despite utilization patterns suggestive of more severe disease.
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Authors: Yuhree Kim; Maria Blomberg; Sheryl L Rifas-Shiman; Carlos A Camargo; Diane R Gold; Jacob P Thyssen; Augusto A Litonjua; Emily Oken; Maryam M Asgari Journal: J Invest Dermatol Date: 2018-11-08 Impact factor: 8.551
Authors: Samuel L Dickman; Adam Gaffney; Alecia McGregor; David U Himmelstein; Danny McCormick; David H Bor; Steffie Woolhandler Journal: JAMA Netw Open Date: 2022-06-01