Barriers to Prescribing Controller Anti Inflammatory Medication among Puerto Rican Asthmatic Children with Public Insurance: Results of National Survey of Pediatricians.
Barriers to Prescribing Controller Anti Inflammatory Medication among Puerto Rican Asthmatic Children with Public Insurance: Results of National Survey of Pediatricians.
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DOI：
10.1089/ped.2010.0023
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发表时间：
2010-11-01
期刊：
影响因子：
--
通讯作者：
Rand C
中科院分区：
文献类型：
--
作者：
Canino G;Vila D;Cabana M;Quiñones A;Otero M;Acosta E;Pabón-Cruz K;Colón FM;Rand C
波多黎各有公共保险的儿童与有私人保险的儿童在分配治疗哮喘的长期控制药物方面存在很大差异。波多黎各的公共健康保险政策包括在首都支付给初级保健医生和诊所的药费。调查问卷邮寄给所有在波多黎各医师学院注册的儿科医生（n=798），以及一些未在该学院注册的儿科医生（n=25），共计823名儿科医生。其中，722名是合格的儿科医生，458名回应调查，回复率为63.4%。大多数受访者表示对国家哮喘教育和预防计划（NAEPP）指南（71.7%）和NAEPP关于控制哮喘药物使用的建议（73.5%）中度至非常熟悉。然而，儿科医生报告的给有公共健康保险的儿童开控制哮喘药物处方的最常见障碍是，不足的人均收入不足以支付哮喘药物（86.2%）和患者缺乏足够的健康保险覆盖（83.2%）。向这些儿童提供控制哮喘药物的最常见策略是口服药物处方（59.5%）和赠送样品（44.7%）。波多黎各目前的公共健康保险政策不利于为患有哮喘的儿童开具适当的长期控制药物。为了提高波多黎各儿童哮喘护理的质量，有必要修订这项公共健康保险政策。
There are substantial disparities in dispensing patterns of long term control medications for asthma among children in Puerto Rico with public insurance as compared to those with private insurance. Public health insurance policy in Puerto Rico includes the cost of medications in the capitation paid to the primary care physicians and clinics. Survey questionnaires were mailed to all pediatricians enrolled in the Puerto Rico College of Physicians (n=798) in addition to some pediatricians not enrolled in the College (n=25) for a total of 823 pediatricians. Of these, 722 were eligible pediatricians with 458 responding to the survey for a response rate of 63.4%. Most of the respondents expressed being moderately to very familiar with the National Asthma Education and Prevention Program (NAEPP) guidelines (71.7%) and with the NAEPP recommendations for controller asthma medication use (73.5%). Inadequate capitation to cover asthma medication (86.2%) and lack of adequate health insurance coverage of the patient (83.2%) however, were the most frequent barriers reported by pediatricians for prescribing controller asthma medication to children with public health insurance. The most frequent strategies used to provide controller asthma medication to these children were prescription of oral medications (59.5%) and giving away samples (44.7%). Current public health insurance policy in Puerto Rico creates a disincentive to the appropriate prescription of long term control medication for children with asthma. To improve the quality of asthma care of children in Puerto Rico, revision of this public health insurance policy is necessary.
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影响因子：
7.2
作者：
Asch, DA;Jedrziewski, MK;Christakis, NA
通讯作者：
Christakis, NA
影响因子：
1.6
作者：
Cabana, Michael D.;Abu-Sa, Heba;Yawn, Barbara
通讯作者：
Yawn, Barbara
影响因子：
3.4
作者：
Lozano, P;Grothaus, LC;Lieu, TA
通讯作者：
Lieu, TA
影响因子：
--
作者：
Cabana, MD;Rand, CS;Rubin, HR
通讯作者：
Rubin, HR
影响因子：
8
作者：
Flores, G;Lee, M;Kastner, B
通讯作者：
Kastner, B