Department of Internal Medicine, Division of Allergy and Clinical Immunology, Rush University Medical Center, Chicago, Ill; Department of Pediatrics, Rush University Medical Center, Chicago, Ill.
Section of Allergy and Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colo.
J Allergy Clin Immunol Pract. 2022 Aug;10(8):2109-2116. doi: 10.1016/j.jaip.2022.04.025. Epub 2022 May 5.
Inconsistent and unequal access to medical care is an issue that predates the COVID19 pandemic, which only worsened the problem. Limited access to care from asthma specialists and other specialists treating comorbid diseases may adversely affect asthma.
The purpose of this review is to identify health disparities associated with access to care for asthma, and cost-effectiveness of therapies and interventions addressing this health disparity.
A narrative systematic review was undertaken using MeSH searches of English language articles published in CINAHL, Scopus, or PubMed.
A total of 725 articles were identified. Barriers recognized from the literature included access to diagnostic spirometry, access to specialists, medication formulary restrictions, and issues leading to medical nonadherence. Telemedicine, school-based health care interventions, digital applications, and non-office-based digital spirometry could be used to address these gaps in access to asthma care while potentially being cost-effective.
With the widespread adoption of telemedicine because of the pandemic, and adoption of other mobile services, we now have potential tools that can increase access to asthma care, which can help address this health care inequity. Evidence is limited, but favorable, that some of these tools may be cost-effective.
医疗服务机会不均等问题由来已久，甚至可以追溯到新冠疫情之前，而疫情的出现则使这一问题进一步恶化。哮喘专科医生和治疗合并症的其他专科医生的医疗服务机会有限，这可能会对哮喘产生不利影响。
本综述旨在确定与哮喘患者医疗服务机会相关的健康差异，以及解决这一健康差异的治疗方法和干预措施的成本效益。
采用 CINAHL、Scopus 或 PubMed 中的 MeSH 搜索，对发表于英文期刊的文章进行叙述性系统综述。
共确定了 725 篇文章。文献中发现的障碍包括诊断性肺量计检查机会有限、专科医生资源有限、药物处方限制以及导致医疗不依从的问题。远程医疗、基于学校的医疗保健干预措施、数字应用程序和非诊室数字肺量计检查等手段可以用来解决哮喘护理机会不均等的问题，同时也可能具有成本效益。
由于疫情的广泛采用，以及其他移动服务的采用，我们现在有了潜在的工具，可以增加哮喘护理的机会，从而有助于解决这一医疗保健不公平问题。虽然证据有限，但有一些有利的证据表明，其中一些工具可能具有成本效益。
