203355 Racial/ethnic variations in asthma prevalence and health services in the US and among the Medicaid population: 2003 - 2005

Tuesday, November 10, 2009: 3:30 PM

M. Beth Benedict, DrPH, JD, RN , Office of Research, Development and Information, CMS liaison to NIH on asthma in the Medicaid population, Centers for Medicare & Medicaid Services, Riviera Beach, MD
National survey data and CMS Medicaid claims data show that the rates of asthma prevalence and health services remain markedly higher among blacks than whites. National prevalence averaged 8.5% for children; 6.7% for adults; and, in Medicaid 7% for children; 5% for adults. Findings are mixed for Non-black Hispanics. This study examined race/ethnicity variations in current asthma care using the CMS Medicaid Analytic eXtract (MAX) database including all states and the District of Columbia and analyzed by the authors. It included fee-for-service, primary care case management, and managed care claims to the extent that they were submitted. Current asthma refers to having some service for asthma during a year. Race/ethnicity variations differ markedly for preschoolers, grade-schoolers and high-schoolers and adults. For acute care rates were highest among pre-schoolers, young boys, and blacks- with little improvement toward meeting the US Healthy People 2010 goal. Ambulatory care increased showing improvement in addressing the NIH/NAEPP goal of controlling asthma. Using Medicaid asthma-related prescriptions, findings showed that approximately 20% of Medicaid beneficiaries with asthma had no asthma-related drug claim; blacks had fewer claims. These findings are important for national and local programs on asthma. They raise important public health concerns about a need to minimize barriers to access, and to insure that individuals with asthma in every community setting receive timely and appropriate ambulatory care and education according to the NIH/NAEPP guidelines. (Other sources: HHS Office of Minority Health website on Asthma and African American statistics; MMWR 2007; NCHS Advance Data, 12/2006).

Learning Objectives:
Discuss racial/ethnic variations in asthma prevalence and the use of health services among the US population as compared with the Medicaid population across a 3-year period. Discuss Medicaid asthma-related prescription fills in relation to the NIH/National Asthma Education and PRevention Program Guidelines for drugs in asthma care plans. Compare Medicaid and National rates using the NHIS, BRFSS and other databases. Discuss US Healthy People 2010 goal to reduce the need for acute care for asthma, especially among blacks.

Keywords: Health Disparities, Asthma

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the researcher who conducted the Medicaid analyses at CMS. I have conducted Medicaid research on asthma for several years as well as on other Medicaid populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.