Purpose: African Americans (AA) with asthma may be disproportionate users of hospitals and emergency departments (ED) partially due to differential access to non-emergent care. We evaluated whether financial access, primary and specialty care use, and prescription drug use differed by race among children with asthma. Controlling for these measures, we explored whether racial differences in hospital and ED use existed.
Methods: Using automated claims data, children aged 5-14 enrolled in a large urban HMO who incurred two outpatient visits or one hospitalization for asthma (ICD-9-CM=493) and had at least one primary care provider (PCP) visit during the year were identified (n=452, 44% AA). Chi-square and Wilcoxon rank sum tests were used to evaluate racial differences in access, and logistic regression models were fit to evaluate racial differences in use, controlling for access.
Results: AA faced lower co-pays (drug and visit), had fewer PCP visits (asthma and total), and filled more maintenance prescriptions. No differences in specialty care use by race existed. AA were more likely to incur an asthma hospitalization (6% vs. 2%), but no differences in asthma-related ED use existed. Once controlling for these access measures, no racial differences existed in use.
Conclusions: Among an HMO population with at least one visit to a PCP, we found no differences in ED and hospital use by race once measures reflective of access to non-emergent care were considered. More research is needed to understand why AA children with asthma had fewer PCP visits.
Learning Objectives: After this presentation the participant will be better able to evaluate health care utilization data and be able to identify differences in utilization patterns
Keywords: Asthma, Health Care Utilization
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.