Race/ethnicity differences in asthma health services and prescription fills among the Medicaid population, with an emphasis on enrolled children

Asthma is the most common chronic condition among children in this country, a prevalence of 8.5% in the general population and 7+% in the Medicaid. The National Health Interview Survey and CMS Medicaid and CHIP claims data show that ambulatory health services remain markedly higher among blacks than whites. This study examined the 2005 race/ethnicity variations in asthma care using the CMS Medicaid Analytic eXtract (MAX) database of all states and the District of Columbia. Included were fee-for-service, primary care case management, and encounter claims as reported by the states. Race/ethnicity rates, odds ratios and p values for ambulatory care (combined visits to providers including clinics, nurses, outpatient hospital and doctor's office) will be reported for preschoolers (relevant for Head Start and other settings), grade-schoolers and high-schoolers because of differences by age group and gender. Preschool boys who are black needed the most emergency asthma care. Rates among girls increased with age. Among all children, blacks have the highest rates of emergency care, followed by Hispanics children. However, white children are more likely to have asthma-related prescriptions filled than are minority children. Findings demonstrate the importance for state Medicaid and local health system strategies to reduce these disparities. They raise important public health concerns about a need to facilitate getting Medicaid-enrolled or eligible children, and CHIP children into the health care system for timely and appropriate asthma care and prescriptions. (Other sources: HHS Office of Minority Health website on Asthma and African American statistics; MMWR 2007; NCHS Advance Data, 12/2006).