Ali S, Osberg J S
Harvard School of Public Health, Boston, MA, USA.
J Health Care Poor Underserved. 1997 Feb;8(1):83-98. doi: 10.1353/hpu.2010.0450.
Asthma-related hospitalizations and mortality have risen at alarming rates in the past two decades, taking a disproportionate toll on African American children. Adverse asthma outcomes have been attributed to inadequacies in primary care, raising concerns about the quality of primary care delivered to African American children. To assess differences in care between African American and white children, the authors identified 500 children enrolled in Massachusetts Medicaid and hospitalized for asthma, and reviewed their medical claims data for the six-month period after hospitalization. It was found that African American children had significantly fewer primary care visits than their white counterparts, even after adjusting for potential confounding variables. In contrast, emergency service utilization did not differ by race. The authors conclude that racial disparity exists in primary care access among children with asthma. Interventions should be designed to target poor African American children who suffer disproportionately from this life-threatening yet treatable disease.
在过去二十年中，与哮喘相关的住院率和死亡率以惊人的速度上升，给非裔美国儿童带来了不成比例的沉重负担。哮喘不良后果被归因于初级保健的不足，这引发了对为非裔美国儿童提供的初级保健质量的担忧。为了评估非裔美国儿童和白人儿童在医疗护理方面的差异，作者确定了500名参加马萨诸塞州医疗补助计划并因哮喘住院的儿童，并审查了他们住院后六个月期间的医疗理赔数据。研究发现，即使在调整了潜在的混杂变量后，非裔美国儿童的初级保健就诊次数仍明显少于白人儿童。相比之下，急诊服务的利用率在种族上没有差异。作者得出结论，哮喘儿童在获得初级保健方面存在种族差异。应设计干预措施，以针对那些在这种危及生命但可治疗的疾病中遭受不成比例痛苦的贫困非裔美国儿童。
