Fischer Alexander H, Shin Daniel B, Margolis David J, Takeshita Junko
Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvannia.
J Am Acad Dermatol. 2017 Dec;77(6):1060-1067. doi: 10.1016/j.jaad.2017.08.035. Epub 2017 Sep 28.
Eczema is a common chronic inflammatory disease of the skin. Studies suggest differences in disease prevalence and severity by race/ethnicity. Our knowledge of health care utilization for eczema among different racial/ethnic groups remains limited.
To evaluate health care utilization for childhood eczema among different racial/ethnic groups in the United States.
We performed a cohort study of non-Hispanic white (reference), non-Hispanic black, and Hispanic white individuals under the age of 18 years with caregiver-reported eczema (N = 2043) pooled from the 2-year longitudinal cohorts of the 2001-2013 Medical Expenditure Panel Surveys. Health care utilization outcomes were evaluated over the 2-year follow-up period by race/ethnicity using multivariable regression.
Among all children with eczema, non-Hispanic blacks were less likely than whites to report an ambulatory visit for eczema (adjusted odds ratio [OR] 0.69; 95% confidence interval [CI] 0.51-0.92). Among those with ≥1 ambulatory visit for eczema, non-Hispanic blacks reported more visits (adjusted incidence rate ratio [IRR] 1.68; 95% CI 1.10-2.55) and prescriptions (IRR 1.22; 95% CI 1.01-1.46) than whites and were more likely than whites to report a dermatology visit (OR 1.82; 95% CI 1.06-3.14) for eczema.
We used caregiver- or self-reported data.
Our findings suggest disparities in health care utilization for eczema among non-Hispanic black children despite utilization patterns suggestive of more severe disease.
湿疹是一种常见的慢性皮肤炎症性疾病。研究表明，不同种族/族裔的疾病患病率和严重程度存在差异。我们对不同种族/族裔群体中湿疹的医疗保健利用情况的了解仍然有限。
评估美国不同种族/族裔群体中儿童湿疹的医疗保健利用情况。
我们对2001 - 2013年医疗支出面板调查的2年纵向队列中汇总的18岁以下有照顾者报告患湿疹的非西班牙裔白人（参照组）、非西班牙裔黑人及西班牙裔白人个体进行了队列研究（N = 2043）。在2年的随访期内，通过多变量回归按种族/族裔评估医疗保健利用结果。
在所有患湿疹的儿童中，非西班牙裔黑人比白人报告因湿疹进行门诊就诊的可能性更低（调整优势比[OR] 0.69；95%置信区间[CI] 0.51 - 0.92）。在那些因湿疹进行≥1次门诊就诊的儿童中，非西班牙裔黑人报告的就诊次数（调整发病率比[IRR] 1.68；95% CI 1.10 - 2.55）和处方量（IRR 1.22；95% CI 1.01 - 1.46）比白人更多，且比白人更有可能报告因湿疹进行皮肤科就诊（OR 1.82；95% CI 1.06 - 3.14）。
我们使用了照顾者报告或自我报告的数据。
我们的研究结果表明，尽管非西班牙裔黑人儿童的疾病模式提示病情更严重，但在湿疹的医疗保健利用方面仍存在差异。
