Asthma Care Quality, Language, and Ethnicity in a Multi-State Network of Low-Income Children.
Asthma Care Quality, Language, and Ethnicity in a Multi-State Network of Low-Income Children.
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DOI：
10.3122/jabfm.2020.05.190468
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发表时间：
2020-09
期刊：
影响因子：
--
通讯作者：
Marino M
中科院分区：
文献类型：
--
作者：
Heintzman J;Kaufmann J;Lucas J;Suglia S;Garg A;Puro J;Giebultowicz S;Ezekiel-Herrera D;Bazemore A;Marino M
先前的研究已经记录了拉丁裔儿童和非西班牙裔白人之间哮喘结果的差异，但很少有研究直接研究在临床环境中随着时间的推移为拉丁裔儿童提供的护理。我们利用基于电子健康记录的数据集，研究了13年研究期间拉丁裔（西班牙语偏好和英语偏好）和非西班牙裔白色儿童之间的基本哮喘护理利用（及时诊断文件和药物处方）。在我们的研究人群（n = 37，614）中，拉丁裔儿童比非西班牙裔白色儿童更容易获得医疗补助，低收入和肥胖。与非西班牙裔白人相比，拉丁裔（西班牙语偏好和英语偏好）在诊断的第一天将哮喘记录在问题列表中的几率较低（比值比[OR]= 0.83; 95%CI，0.77至0.89西班牙语偏好; OR = 0.93; 95%CI，0.87至0.99英语偏好）。偏好西班牙语的拉美裔人接受沙丁胺醇（OR = 1.96; 95%CI，1.52至2.52）、吸入性皮质类固醇（OR = 1.45; 95%CI，1.01至2.09）或口服类固醇（OR = 1.48; 95%CI，1.07至2.04）处方的几率高于非西班牙裔白人。在有任何处方的人群中，偏好西班牙语的拉丁裔比非西班牙裔白人有更高的沙丁胺醇处方率（调整率比[aRR]= 1.0; 95%CI，1.01 - 1.13）。在一个多州的诊所网络中，拉丁裔儿童在发现哮喘的第一天就被列入问题清单的可能性低于非西班牙裔白色儿童，但在其他方面，他们接受的治疗并不比非西班牙裔白色儿童差。进一步的研究可以检查哮喘护理连续体的其他部分，以更好地了解哮喘差异。（J Am Board Fam Med 2020; 33：707 - 715.）
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. 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. 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). 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. (J Am Board Fam Med 2020;33:707–715.)
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DOI：
10.1177/1077558711404434
发表时间：
2011-12
期刊：
Medical care research and review : MCRR
影响因子：
--
作者：
Jandasek B;Ortega AN;McQuaid EL;Koinis-Mitchell D;Fritz GK;Kopel SJ;Seifer R;Klein RB;Canino G
通讯作者：
Canino G
影响因子：
1.9
作者：
Bruzzese, Jean-Marie;Stepney, Cesalie;Evans, David
通讯作者：
Evans, David
DOI：
10.1111/j.2044-8317.2011.02031.x
发表时间：
2012-02-01
影响因子：
2.6
作者：
Loeys, Tom;Moerkerke, Beatrijs;Buysse, Ann
通讯作者：
Buysse, Ann
影响因子：
9.7
作者：
Coleman, Katie;Austin, Brian T.;Wagner, Edward H.
通讯作者：
Wagner, Edward H.
影响因子：
2.9
作者：
Mojica, Cynthia M.;Bastani, Roshan
通讯作者：
Bastani, Roshan