照顾者语言偏好与哮喘儿童的医疗保健利用。

Caregiver Language Preference and Health Care Utilization Among Children With Asthma.

机构信息

Division of Emergency Medicine.

Center for Translational Research.

出版信息

Pediatrics. 2023 Dec 1;152(6). doi: 10.1542/peds.2023-061869.

DOI:10.1542/peds.2023-061869

PMID:37964708

Abstract

BACKGROUND AND OBJECTIVES

Asthma is a leading cause of health care utilization in children and disproportionately affects historically marginalized populations. Yet, limited data exist on the role of caregiver language preference on asthma morbidity. The study aim was to determine whether caregiver non-English language preference (NELP) is associated with unscheduled asthma-related health care utilization in pediatric patients.

METHODS

This was a retrospective cohort study using data from a population-level, disease-specific registry of pediatric patients with asthma living in the District of Columbia (DC). Patients aged 2 to 17 years were included and the study period was 2019. The primary exposure variable was language preference: English preferred (EP) or NELP by self-identified language preference. The primary outcome was unscheduled asthma-related health care utilization including emergency department visits, hospitalizations (ICU and non-ICU), and ICU visits alone. Logistic regression was used to calculate adjusted odds ratios (aORs).

RESULTS

Of the 14 431 patients included, 8.1% had NELP (1172 patients). In analyses adjusted for age, sex, ethnicity, insurance status, diagnosis of persistent asthma, controller prescription, and encounter with a primary care provider, caregiver NELP was associated with an increased odds of having an asthma-related emergency department visit (aOR, 1.37; 95% CI, 1.08-1.74), hospitalization (aOR, 1.79; 95% CI, 1.18-2.72), and ICU visit (aOR, 4.37; 95% CI, 1.93-9.92). In the Hispanic subgroup (n = 1555), caregiver NELP was associated with an increased odds of having an asthma-related hospitalization (aOR, 1.73; 95% CI, 1.02-2.93).

CONCLUSIONS

In the population of children in the District of Columbia with asthma, caregiver NELP was associated with increased odds of asthma-related health care utilization, suggesting that caregiver language preference is a significant determinant of asthma outcomes.

摘要

背景与目的

哮喘是儿童医疗保健利用的主要原因，且不成比例地影响历史上处于边缘地位的人群。然而，关于照顾者语言偏好对哮喘发病率的影响，相关数据有限。本研究旨在确定照顾者非英语语言偏好（NELP）是否与儿科患者哮喘相关的非计划性医疗保健利用有关。

方法

这是一项回顾性队列研究，使用了来自哥伦比亚特区（DC）一个特定于疾病的儿科哮喘患者人群水平登记处的数据。纳入年龄在 2 至 17 岁的患者，研究期间为 2019 年。主要暴露变量为语言偏好：自我认定的语言偏好为英语偏好（EP）或 NELP。主要结局是未计划的哮喘相关医疗保健利用，包括急诊就诊、住院（ICU 和非 ICU）和 ICU 就诊。使用逻辑回归计算调整后的优势比（aOR）。

结果

在纳入的 14431 名患者中，有 8.1%（1172 名）有 NELP。在调整年龄、性别、族裔、保险状况、持续性哮喘诊断、控制器处方和初级保健提供者就诊后，照顾者的 NELP 与哮喘相关急诊就诊的几率增加有关（aOR，1.37；95%CI，1.08-1.74）、住院（aOR，1.79；95%CI，1.18-2.72）和 ICU 就诊（aOR，4.37；95%CI，1.93-9.92）。在西班牙裔亚组（n=1555）中，照顾者的 NELP 与哮喘相关住院的几率增加有关（aOR，1.73；95%CI，1.02-2.93）。