Essentia Institute of Rural Health, Division of Research, 502 E Second St, Duluth, MN 55805, USA.
J Natl Med Assoc. 2012 May-Jun;104(5-6):275-85. doi: 10.1016/s0027-9684(15)30157-7.
Asthma is one of the most common and costly illnesses of childhood. This study addresses health services deficits experienced by school-aged children with asthma.
Analyzing data from the 2007-2008 National Survey of Child Health, this cross-sectional study used household income, race/ethnicity, and geographic residency as the primary independent variables and health service deficits as the dependent variable.
Multivariate analysis yielded that other/multiracial (odds ratio [OR], 1.234; 95% confidence interval [CI], 1.226-1.242) and Hispanic (OR, 2.207; 95% CI, 1.226-1.242) school-aged children with asthma had greater odds of having health services deficits as did both urban (OR, 1.106; 95% CI, 1.099-1.113) and rural (OR, 1.133; 95% CI, 1.124-1.142) school-aged children with asthma. Children with either moderate (OR, 1.195; 95% CI, 1.184-1.207) or mild (OR, 1.445; 95% CI, 1.431-1.459) asthma had greater odds of having a health services deficit than those with severe asthma. Low-income school-aged children with asthma had greater odds of having a health services deficit than high-income children (OR, 1.031; 95% CI, 1.026-1.036). At lesser odds of having a health service deficit were those who were African American, of middle-range income, male, or who were school-aged children with asthma in good to excellent health.
Both African American and other/multiracial school-aged children were at greater risk of having asthma than either Caucasian or Hispanic children. Three vulnerable subgroups of school-aged children with asthma-rural, Hispanic, and those of low income were the most likely to have health service deficits.
哮喘是儿童中最常见和最昂贵的疾病之一。本研究旨在探讨学龄期哮喘儿童所经历的卫生服务缺陷。
本横断面研究分析了 2007-2008 年全国儿童健康调查的数据,使用家庭收入、种族/民族和地理位置作为主要的自变量,以卫生服务缺陷为因变量。
多变量分析显示,其他/多种族(比值比[OR],1.234;95%置信区间[CI],1.226-1.242)和西班牙裔(OR,2.207;95%CI,1.226-1.242)学龄期哮喘儿童更有可能出现卫生服务缺陷,城市(OR,1.106;95%CI,1.099-1.113)和农村(OR,1.133;95%CI,1.124-1.142)的学龄期哮喘儿童也是如此。中重度(OR,1.195;95%CI,1.184-1.207)或轻度(OR,1.445;95%CI,1.431-1.459)哮喘的儿童比重度哮喘的儿童更有可能出现卫生服务缺陷。低收入的学龄期哮喘儿童比高收入的儿童更有可能出现卫生服务缺陷(OR,1.031;95%CI,1.026-1.036)。而那些非裔美国人、中等收入、男性或身体状况良好或优秀的学龄期哮喘儿童出现卫生服务缺陷的可能性较小。
非裔美国人和其他/多种族的学龄期哮喘儿童比白种人或西班牙裔儿童更有可能患哮喘。农村、西班牙裔和低收入这三个弱势群体的学龄期哮喘儿童最有可能出现卫生服务缺陷。