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

Abstract #118427

M. Beth Benedict, DrPH, JD, Office of Research, Development and Information, Centers for Medicare and Medicaid Services, 867 DeFranceaux Harbour, Riviera, MD 21122, 410-786-7724, bbenedict@cms.hhs.gov

The purpose of this study was to develop national statistics on the race/ethnicity variations in the utilization of health care services and expenditures for the common chronic condition of asthma, using the new Centers for Medicare and Medicaid Services Medicaid Analytic eXtract (MAX) database that allows for nationally representative patterns and statistics. The databases included all fee-for-service and primary care case management claims, and the pre-paid managed care claims to the extent that they were reported to CMS. The study included the total population from all states and DC of enrolled non-elderly adults who had at least one claim for a primary diagnosis of asthma. The new 2000 analyses showed variations in rates by race/ethnicity for use of inpatient care, and significantly higher rates of inpatient asthma care among middle-aged Black females but usually lower rates among Hispanics than for whites. Odds ratios and probabilities showed significantly higher likelihood of high-cost care among minorities in general. On average, the minorities accounted for more acute care episodes with a relatively high percentage of inpatient stays for status asthmaticus, more comorbidities, more intense use of services, more costly episodes of care, but they experienced fewer inpatient days than non-minorities. Findings showed that most rates for the Medicaid-cover population were about 2 times that of the 2010 Healthy People Goals for the population in general, and for some cohorts were more than 3 times that of the goals. These variations in rates suggest that the poor minority populations may be less likely to receive the ambulatory care recommended by the NIH National Asthma Education and Prevention Program (NAEPP) Guidelines even though they are insured. The study also offers insight for health care program administration on the issues of insuring equity in access to quality care for all populations, despite the current reductions in financial and professional workforce resources.

Learning Objectives:

• To discuss a new national profile of minority and non-minority Medicaid-covered non-elderly adults who received care for asthma in 2000 using data from all states and the District of Columbia in comparison to a prior analyses of 1999 data.
• To explain race-ethnicity national variations in utilization and expenditure rates for inpatient stays, selected severity factors and Medicaid program expenditures.

Keywords: Asthma, Health Disparities

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.