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探索美国学龄儿童哮喘及哮喘控制不佳方面健康差异的相关因素

Exploring factors associated with health disparities in asthma and poorly controlled asthma among school-aged children in the U.S.

作者信息

Sullivan P W, Ghushchyan V, Navaratnam P, Friedman H S, Kavati A, Ortiz B, Lanier B

机构信息

Regis University School of Pharmacy, Denver, Colorado, USA.

University of Colorado, Denver, Colorado, USA.

出版信息

J Asthma. 2020 Mar;57(3):271-285. doi: 10.1080/02770903.2019.1571080. Epub 2019 Feb 7.

Abstract

: Certain populations suffer disproportionately from asthma and asthma morbidity. The objective was to provide a national descriptive profile of asthma control and treatment patterns among school-aged children (SAC: aged 6-17) in the U.S. : This was a cross-sectional analysis using the nationally representative 2007-2014 Medical Expenditure Panel Survey. Among SAC with asthma, indicators of poor control included: exacerbation/asthma attack; >3 canisters short-acting beta agonist (SABA)/3 months; and asthma-specific Emergency Department or inpatient visits (ED/IP). : Non-Hispanic black, non-Hispanic multiple races, Puerto Rican, obese, Medicaid, poor, ≥2 non-asthma chronic comorbidities (CC), and family average CC ≥ 2 were associated with higher odds of having asthma. The following had significantly higher odds ratios (OR) of excessive SABA use compared to non-Hispanic whites [OR; CI;  < 0.05]: Puerto Rican (3.8; 2.1-6.9), Mexican (3.6; 2.0-6.4), Central/South American (3.0; 1.2-7.7), Hispanic-other (3.1; 1.1-9.0), non-Hispanic black (2.5; 1.6-3.9), and non-Hispanic Asian (4.0; 1.7-9.2). SABA OR were also significant for Spanish spoken at home (2.5; 1.6-3.8), obese (2.1; 1.3-3.3), Medicaid (2.9; 2.0-4.1), no medical insurance (2.1; 1.1-4.1), no prescription insurance (2.5; 1.8-3.5), poor (2.8; 1.7-4.7), CC ≥ 2 (2.1; 1.6-2.8), parent-without high-school degree (2.5; 1.8-3.6), parent-SF-12 Physical Component Scale <50 (1.6; 1.2-2.1) and Mental Component Scale <50 (1.5; 1.1-2.0). Significant differences also existed across subgroups for ED/IP visits. : There are disparities in asthma control and prevalence among certain populations in the U.S. These results provide national data on disparities in several indicators of poor asthma control beyond the standard race/ethnicity groupings.

摘要

某些人群患哮喘及哮喘发病的比例过高。目的是提供美国学龄儿童(6至17岁)哮喘控制和治疗模式的全国性描述概况。这是一项横断面分析,使用具有全国代表性的2007 - 2014年医疗支出面板调查。在患有哮喘的学龄儿童中,控制不佳的指标包括:病情加重/哮喘发作;每3个月使用超过3罐短效β受体激动剂(SABA);以及因哮喘到急诊科就诊或住院治疗(ED/IP)。非西班牙裔黑人、非西班牙裔多种族、波多黎各人、肥胖者、医疗补助人群、贫困人群、患有≥2种非哮喘慢性合并症(CC)以及家庭平均CC≥2的人群患哮喘的几率更高。与非西班牙裔白人相比,以下人群过度使用SABA的几率显著更高[比值比(OR);置信区间(CI);<0.05]:波多黎各人(3.8;2.1 - 6.9)、墨西哥人(3.6;2.0 - 6.4)、中/南美洲人(3.0;1.2 - 7.7)、其他西班牙裔(3.1;1.1 - 9.0)、非西班牙裔黑人(2.5;1.6 - 3.9)以及非西班牙裔亚洲人(4.0;1.7 - 9.2)。在家说西班牙语(2.5;1.6 - 3.8)、肥胖(2.1;1.3 - 3.3)、医疗补助(2.9;2.0 - 4.1)、无医疗保险(2.1;1.1 - 4.1)、无处方药保险(2.5;1.8 - 3.5)、贫困(2.8;1.7 - 4.7)、CC≥2(2.1;1.6 - 2.8)、父母没有高中学历(2.5;1.8 - 3.6)、父母SF - 12身体成分量表<50(1.6;1.2 - 2.1)以及精神成分量表<50(1.5;1.1 - 2.0)的人群,其SABA的OR值也具有显著性。在ED/IP就诊方面,各亚组之间也存在显著差异。美国某些人群在哮喘控制和患病率方面存在差异。这些结果提供了关于哮喘控制不佳的几个指标差异的全国性数据,超出了标准的种族/族裔分组。

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