From the Department of Pediatrics, Nemours Children's Health, Orlando, Florida.
the Division of Clinical Trials and Biostatistics, Mayo Clinic College of Medicine, Jacksonville, Florida.
South Med J. 2024 Oct;117(10):603-608. doi: 10.14423/SMJ.0000000000001743.
Atopic dermatitis (AD) is one of the most common chronic childhood conditions. Disparities in treatment and access to care can result in poor disease control and decreased quality of life. The aim of this study was to determine whether race and ethnicity affect treatment and healthcare utilization for pediatric atopic dermatitis in central Florida.
This study of 4008 children with AD compared healthcare utilization and management using the numbers of AD-related healthcare visits, prescriptions, testing, and subspecialty referrals. Multivariable models were used to compare racial and ethnic groups (Black, Hispanic, Asian, and Other) with the reference group of non-Hispanic White, while adjusting for common confounders.
The mean number of urgent care visits for the Hispanic group was 1.61 times that of the non-Hispanic White group, and the mean number of emergency department visits was 3.71 ( 0.001) times the reference group. Black or African American patients had a mean number of emergency department visits that was 1.52 times that of non-Hispanic White patients ( 0.021). The mean count of primary care visits was lower among Hispanic patients and higher among Asian patients ( 0.012). Visits to subspecialty clinics and hospitalizations did not differ significantly. There were no consistent patterns in differences of AD-related prescriptions, testing, or subspecialty referrals.
This study indicates that racial and ethnic disparities exist in healthcare utilization in pediatric AD. The underlying factors contributing to these disparities need to be further studied and addressed to reach health equity within pediatric AD.
特应性皮炎（AD）是最常见的儿童慢性疾病之一。治疗和获得医疗服务的差异可能导致疾病控制不佳和生活质量下降。本研究旨在确定种族和民族是否会影响佛罗里达州中部儿童特应性皮炎的治疗和医疗保健利用情况。
这项针对 4008 名 AD 患儿的研究比较了与 AD 相关的医疗保健就诊次数、处方、检测和专科转介的医疗保健利用和管理情况。使用多元模型比较了黑种人、西班牙裔、亚洲人和其他种族与非西班牙裔白人的种族和民族群体，同时调整了常见混杂因素。
西班牙裔群体的急诊就诊次数中位数是白人非西班牙裔群体的 1.61 倍，急诊就诊次数中位数是参考组的 3.71 倍（P<0.001）。黑种人或非裔美国人的急诊就诊次数中位数是白人非西班牙裔的 1.52 倍（P=0.021）。西班牙裔患者的初级保健就诊次数中位数较低，而亚洲患者的就诊次数中位数较高（P=0.012）。专科诊所就诊次数和住院治疗无显著差异。AD 相关处方、检测或专科转介方面也没有一致的差异模式。
本研究表明，儿科 AD 患者的医疗保健利用存在种族和民族差异。需要进一步研究导致这些差异的潜在因素，并解决这些问题，以实现儿科 AD 中的健康公平。
