Kim Hyoshin, Kieckhefer Gail M, Greek April A, Joesch Jutta M, Baydar Nazli
Battelle Centers for Public Health Research and Evaluation, 1100 Dexter Ave N, Ste 400, Seattle, WA 98109-3598, USA.
Prev Chronic Dis. 2009 Jan;6(1):A12. Epub 2008 Dec 15.
We examined how differences in health service utilization among children with asthma are associated with race/ethnicity, socioeconomic status (family income, mother's education), and health insurance coverage.
We analyzed Medical Expenditure Panel Survey data from 1996 through 2000 (982 children younger than 18 years with asthma). We calculated percentages and mean distributions, odds ratios, and incidence rate ratios.
Non-Hispanic black children used more urgent care services and fewer preventive health services. Children in low-income families (125%-199% of the poverty line) had the lowest levels of prescription fills and general checkups. Children whose mothers had more education had more checkups and fewer emergency department visits. Children who were insured during the 2-year study period used more health services for asthma, not including emergency department visits.
Minority children and children of socioeconomically disadvantaged families use more urgent care and less preventive care for asthma. Children without health insurance use fewer health services overall. Future research should address how related factors might explain health services utilization in effectively managing asthma in children.
我们研究了哮喘患儿在医疗服务利用方面的差异如何与种族/族裔、社会经济地位(家庭收入、母亲受教育程度)以及医疗保险覆盖情况相关联。
我们分析了1996年至2000年的医疗支出面板调查数据(982名18岁以下的哮喘患儿)。我们计算了百分比、平均分布、比值比和发病率比。
非西班牙裔黑人儿童使用更多紧急护理服务,而预防性健康服务较少。低收入家庭(贫困线的125% - 199%)的儿童处方配药和常规体检水平最低。母亲受教育程度较高的儿童体检次数更多,急诊就诊次数更少。在为期两年的研究期间有保险的儿童使用更多的哮喘医疗服务,但不包括急诊就诊。
少数族裔儿童和社会经济处于不利地位家庭的儿童在哮喘治疗中使用更多紧急护理,而预防性护理较少。没有医疗保险的儿童总体上使用的医疗服务较少。未来的研究应探讨相关因素如何解释在有效管理儿童哮喘方面医疗服务的利用情况。