Asthma care quality, language, and ethnicity in a multi-state network of low-income children

John Heintzman, Jorge Kaufmann, Jennifer Lucas, Shakira Suglia, Arvin Garg, Jon Puro, Sophia Giebultowicz, David Ezekiel-Herrera, Andrew Bazemore, Miguel Marino

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Introduction: Prior research has documented disparities in asthma outcomes between Latino children and non-Hispanic whites, but little research directly examines the care provided to Latino children over time in clinical settings. Methods: We utilized an electronic health record–based dataset to study basic asthma care utilization (timely diagnosis documentation and medication prescription) between Latino (Spanish preferring and English preferring) and Non-Hispanic white children over a 13-year study period. Results: In our study population (n = 37,614), Latino children were more likely to have Medicaid, be low income, and be obese than non-Hispanic white children. Latinos (Spanish preferring and English preferring) had lower odds than non-Hispanic whites of having their asthma recorded on their problem list on the first day the diagnosis was noted (odds ratio [OR] = 0.83; 95% CI, 0.77 to 0.89 Spanish preferring; OR = 0.93; 95% CI, 0.87 to 0.99 English preferring). Spanish-preferring Latinos had higher odds of ever receiving a prescription for albuterol (OR = 1.96; 95% CI, 1.52 to 2.52), inhaled corticosteroids (OR = 1.45; 95% CI, 1.01 to 2.09), or oral steroids (OR = 1.48; 95% CI, 1.07 to 2.04) than non-Hispanic whites. Among those with any prescription, Spanish-preferring Latinos had higher rates of albuterol prescriptions compared with non-Hispanic whites (adjusted rate ratio [aRR] = 1.0; 95% CI, 1.01 to 1.13). Conclusions: In a multi-state network of clinics, Latino children were less likely to have their asthma entered on their problem list the first day it was noted than non-Hispanic white children, but otherwise did not receive inferior care to non-Hispanic white children in other measures. Further research can examine other parts of the asthma care continuum to better understand asthma disparities.

Original languageEnglish (US)
Pages (from-to)707-715
Number of pages9
JournalJournal of the American Board of Family Medicine
Volume33
Issue number5
DOIs
StatePublished - Oct 2020

Keywords

  • Asthma
  • Electronic Health Records
  • Health Care Disparities
  • Hispanic Americans
  • Poverty
  • Practice-Based Research
  • Primary Health Care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Family Practice

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