Child/Adolescent Health

Minority children with asthma frequently use emergency departments for care

Researchers have relied on Medicaid data to make the case that black and Hispanic children who come from low-income families receive care for their asthma from emergency departments (EDs) more often than white children from higher income families. A new study using national Medical Expenditure Panel Survey (MEPS) data reached the same conclusion. Gail M. Kieckhefer, Ph.D., A.R.N.P., of the University of Washington, and colleagues analyzed 1996 to 2000 MEPS data for 982 children with asthma to see if the data correspond with Medicaid data.MEPS is an ongoing, national survey that provides data on the U.S. population's health service use and expenditures and insurance coverage.

The researchers found that black and Hispanic children received asthma care in EDs more often than white children. This was consistent with earlier studies. The authors suggest that ED visits may occur because these children may lack a usual source of care or asthma management strategies at home for when an attack occurs. Improving care access and offering programs to teach caregivers skills to manage asthma may reduce ED visits.

In contrast to earlier findings, the authors did not find differences in filled prescriptions by race or ethnicity. However, children in low-income families (below 200 percent of the poverty level) had fewer health checkups and used more ED care than higher income families. Not surprisingly, children with health insurance were more likely to use health services than children who had no coverage.

The authors suggest that some children from low-income families may not qualify for public insurance and go without care. The authors recommend that the Federal government support public health insurance programs, like the State Children's Health Insurance Program, to ensure children's asthma is managed via office visits, checkups, and prescription medicine. This study was funded in part by the Agency for Healthcare Research and Quality (HS13110).

See "Health care utilization by children with asthma," by Hyoshin Kim, Ph.D., Dr. Kieckhefer, April A. Greek, Ph.D., and others in the January 2009 Preventing Chronic Disease: Public Health Research, Practice and Policy 6(1), pp. 1-11.

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