McRoy Luceta, Weech-Maldonado Robert, Kilgore Meredith
Morehouse School of Medicine, National Center for Primary Care , Atlanta, GA , USA .
J Asthma. 2014 Nov;51(9):922-6. doi: 10.3109/02770903.2014.930880. Epub 2014 Jun 20.
Asthma is a leading cause of emergency department (ED) visits. There has been much debate on the impact of direct to consumer advertising (DTCA) on healthcare. This study seeks to examine the association between DTCA expenditure and asthma-related ED use.
In this study, we combined Medicaid administrative data and a national advertising data on asthma medications. The sample size consisted of 180,584 Medicaid-enrolled children between the ages of 5 and 18 years who had an asthma diagnosis. Twenty percent of the Medicaid-enrolled children in the sample had asthma-related ED visits.
We found that DTCA expenditure is associated with a decrease in asthma-related ED visits (OR = 0.75; CI: 0.64-0.89). However, at higher levels of DTCA expenditure, the likelihood of asthma-related ED visits increases (OR = 1.25; CI: 1.05-1.49), indicating a decreased relationship between DTCA and asthma-related ED visits.
Our findings suggest that DTCA may be associated with improved health outcomes for Medicaid-enrolled children with asthma.
哮喘是急诊科就诊的主要原因。关于直接面向消费者的广告(DTCA)对医疗保健的影响一直存在诸多争议。本研究旨在探讨DTCA支出与哮喘相关的急诊科就诊之间的关联。
在本研究中,我们将医疗补助计划管理数据与哮喘药物的全国广告数据相结合。样本量包括180,584名年龄在5至18岁之间且被诊断患有哮喘的医疗补助计划参保儿童。样本中20%的医疗补助计划参保儿童有哮喘相关的急诊科就诊经历。
我们发现DTCA支出与哮喘相关的急诊科就诊次数减少有关(比值比[OR]=0.75;置信区间[CI]:0.64 - 0.89)。然而,在DTCA支出水平较高时,哮喘相关的急诊科就诊可能性增加(OR = 1.25;CI:1.05 - 1.49),这表明DTCA与哮喘相关的急诊科就诊之间的关系减弱。
我们的研究结果表明,DTCA可能与医疗补助计划参保的哮喘儿童的健康状况改善有关。