Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #105834

Jose Capriles, MD, MHSA¹, Mario H. Rodriguez, PhD, MPH², Ruth Rios, PhD¹, Rene Dávila, MS³, and Yelitza Sánchez, BS⁴. (1) School of Public Health, Department of Health Services Administration, University of Puerto Rico, PO Box 365067, San Juan, PR 00936-5067, (787)758-2525, ext 1440, jcapriles@rcm.upr.edu, (2) School of Public Health, Health Services Administration Department, University of Puerto Rico, P O Box 365067, San Juan, PR 00936-5067, (3) School of Public Health, Human Development Department, University of Puerto Rico, PO Box 365067, San Juan, PR 00936-5067, (4) Puerto Rico Health Services Research Institute, Health Services Administration Department, University of Puerto Rico, School of Public Health, PO Box 365067, San Juan, PR 00936-5067

Statement of the problem: Asthma is the most common chronic lung disease diagnosed in adolescents in Puerto Rico (PR), and affects disproportionately low income populations. The Medicaid Program turned to managed care in an effort to reduce costs, and improve access to high quality healthcare services. Objective: To identify healthcare utilization patterns in adolescents under managed care (MC) and fee-for-service (FFS) insurance models. Procedure: This study explores the patterns of healthcare utilization for adolescents aged 13 to 17 years diagnosed with asthma in a group of beneficiaries of the PR Healthcare Reform (MC), and FFS plan. A total of 9,609 insurance claims between 1999 and 2001 were examined. Healthcare utilization was defined as three continuous variables measuring the frequency of visits and use of a specific type of service in a year. Results: The mean of physician office visits in the FFS plan was 6.89 (SD=11.32) and in the MC plan was 1.38 (SD=1.80). The mean of emergency room visits in the FFS group was 3.97 (SD=3.59) and 1.29 (SD=1.16) for the MC group. Hospital admissions presented a similar trend, 4.5 (SD=4.24) in the FFS and 1.11 (SD=0.43) in the MC group. Statistically significant differences were sustained for each year of study (p< .001) in all variables. Conclusion: These results illustrate differences in the way adolescents have access to care according to their insurance status. This may suggest an "insurance effect" on asthma-related management. Further understanding of the impact of these differences on clinical outcomes could guide asthma improvement efforts.

Learning Objectives:

• •Identify patterns of health services utilization in Adolescents asthma patients.
• •Recognize the differences in the health services utilization in asthma patients considering their insurance status.

Keywords: Asthma, Equal Access

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.