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美国儿童 ICD 编码哮喘诊断中的拉丁裔-白人差异。

Latino-white disparities in ICD-coded asthma diagnosis among US children.

机构信息

Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA.

OCHIN Inc, Portland, OR, USA.

出版信息

J Asthma. 2022 Mar;59(3):514-522. doi: 10.1080/02770903.2020.1861628. Epub 2020 Dec 18.

Abstract

INTRODUCTION

It is uncertain if disparities in asthma diagnosis between Latino and non-Hispanic white children stem from differences in diagnosis over time among children presenting with similar clinical scenarios suggestive of asthma.

METHODS

We evaluated the odds of International Classification of Disease (ICD)-coded asthma diagnosis in Latino (English and Spanish preferring) and non-Hispanic white children, overall ( = 524,456) and among those presenting with possible asthma indicators ( = 85,516) over a 13-year period, using electronic health record data from a multi-state network of community health centers.

RESULTS

Among those with possible asthma indicators, Spanish-preferring Latinos had lower adjusted odds of ICD-coded asthma diagnosis compared to non-Hispanic whites (OR = 0.87, 95%CI = 0.77-0.99); English-preferring Latinos did not differ from non-Hispanic whites. Differences in ICD-coded diagnosis between ethnicity/language groups varied by presenting symptom.

CONCLUSIONS

Spanish-preferring Latino children may be less-likely to have ICD-coded asthma documented in the EHR when presenting with certain clinical indicators suggestive of asthma. Clinicians should be cognizant of the need for the follow-up of these indicators in Spanish-preferring Latino children.

摘要

介绍

尚不确定拉丁裔和非西班牙裔白人群体之间哮喘诊断的差异是否源于在具有类似哮喘临床特征的患儿中,随时间推移而出现的诊断差异。

方法

我们使用来自多州社区卫生中心网络的电子健康记录数据,评估了在 13 年期间,拉丁裔(英语和西班牙语偏好)和非西班牙裔白人群体( = 524,456 名)整体以及具有可能哮喘指标的儿童( = 85,516 名)中,国际疾病分类(ICD)编码哮喘诊断的可能性。

结果

在具有可能哮喘指标的儿童中,西班牙语偏好的拉丁裔儿童与非西班牙裔白人相比,ICD 编码哮喘诊断的调整后比值比(OR)较低(OR = 0.87,95%CI = 0.77-0.99);英语偏好的拉丁裔儿童与非西班牙裔白人没有差异。在表现症状上,种族/语言群体之间 ICD 编码诊断的差异不同。

结论

当出现某些具有哮喘特征的临床指标时,西班牙语偏好的拉丁裔儿童的电子健康记录中可能较少记录 ICD 编码哮喘。临床医生应认识到在西班牙语偏好的拉丁裔儿童中需要对这些指标进行随访。

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