Nazario Sylvette, Casal Jesus R, Torres-Palacios Alfonso, Rodriguez William, Delamater Alan M, Applegate E Brooks, Piedimonte Giovanni, Wanner Adam
Department of Internal Medicine, Veterans Affairs Medical Center, San Juan, Puerto Rico.
Pediatr Pulmonol. 2004 May;37(5):453-60. doi: 10.1002/ppul.20022.
We conducted a survey to determine parent-reported asthma prevalence, morbidity, and healthcare utilization among 3527 children attending public schools (n = 2849) and private schools (n = 678) in San Juan, Puerto Rico. Schools were randomly selected from each of 12 geographic regions of the San Juan metropolitan area. Parents of children age 4-7 years old completed a 12-item questionnaire on asthma diagnosis, respiratory symptoms and morbidity, and healthcare utilization. Parents of children in public schools and private schools reported similar rates of a physician having previously diagnosed asthma in their children (43.2% vs. 39.4%); however, significantly more children in public schools were reported to still have asthma at the time of the survey (32.6% vs. 23.7%). Children attending public schools vs. private schools were reported to have missed significantly more school and to have had more hospitalizations and emergency department visits. Among children reported to still have asthma, significantly more children visited an emergency department, were hospitalized, and missed more school days due to respiratory symptoms in the past year. The high prevalence of parent-reported asthma, respiratory symptoms, and healthcare utilization among Puerto Rican children in San Juan calls for further studies using objective methods for ascertaining asthma and asthma-related morbidity. Differences in healthcare utilization between children attending public vs. private schools suggest that socioeconomic factors play a role in asthma management in Puerto Rico.
我们开展了一项调查，以确定波多黎各圣胡安地区3527名就读于公立学校（n = 2849）和私立学校（n = 678）的儿童中，家长报告的哮喘患病率、发病率及医疗保健利用情况。学校是从圣胡安都会区12个地理区域中随机选取的。4至7岁儿童的家长完成了一份关于哮喘诊断、呼吸道症状与发病率以及医疗保健利用情况的12项问卷。公立学校和私立学校儿童的家长报告其孩子此前被医生诊断为哮喘的比例相近（43.2%对39.4%）；然而，据报告，在调查时公立学校中仍患有哮喘的儿童明显更多（32.6%对23.7%）。据报告，就读于公立学校的儿童比私立学校的儿童缺课天数明显更多，住院次数和急诊就诊次数也更多。在据报告仍患有哮喘的儿童中，过去一年因呼吸道症状前往急诊就诊、住院以及缺课天数更多的儿童明显更多。圣胡安地区波多黎各儿童中家长报告的哮喘、呼吸道症状及医疗保健利用的高患病率，需要采用客观方法进一步研究以确定哮喘及与哮喘相关的发病率。就读于公立学校和私立学校的儿童在医疗保健利用方面的差异表明，社会经济因素在波多黎各的哮喘管理中发挥着作用。
