Abstract：
Higher rates of ED visits and hospitalizations for asthma among African American and Hispanic children may indicate suboptimal management of asthma, leading to a greater financial burden of healthcare. It is not well known if an association of race/ethnicity with controller medication and hospital-based care utilization exists.
This study examines whether the Asthma Medication Ratio (AMR) predicts healthcare utilization for asthma by race/ethnicity.
4,584 Medi-Cal children (Ages 5-11) with persistent asthma in Los Angeles were identified and their AMRs (2018) were calculated based on the HEDIS criteria. Healthcare utilization data were used, including hospitalizations, ED visits, and pharmacy claims to examine whether a higher AMR predicts decreases in healthcare utilization by race/ethnicity in the subsequent 3,6, and 12 months (2019).
The average AMR was lowest among African American children (0.401). In the subsequent 12 months, they were highest in ED visits (0.249) and hospitalizations (0.121), but lowest in outpatient visits (0.793). The results of logistic regression showed that a higher value of AMR (>0.5) contributed to decreases in ED visits in the subsequent 12 months only among African Americans (OR = 0.551, 95% CI 0.364-0.832) and Hispanics (OR = 0.613, 95% CI 0.489-0.770). No association between AMR and hospitalizations was found.
Our findings indicate that increased use of controller medication contributes to a decrease in ED visits among African American and Hispanic children with persistent asthma. Increased use of controller medications and caregiver\'s efforts for medication adherence may contribute to a reduction in asthma disparities.
This study examines whether the Asthma Medication Ratio (AMR) predicts healthcare utilization for asthma by race/ethnicity.
4,584 Medi-Cal children (Ages 5-11) with persistent asthma in Los Angeles were identified and their AMRs (2018) were calculated based on the HEDIS criteria. Healthcare utilization data were used, including hospitalizations, ED visits, and pharmacy claims to examine whether a higher AMR predicts decreases in healthcare utilization by race/ethnicity in the subsequent 3,6, and 12 months (2019).
The average AMR was lowest among African American children (0.401). In the subsequent 12 months, they were highest in ED visits (0.249) and hospitalizations (0.121), but lowest in outpatient visits (0.793). The results of logistic regression showed that a higher value of AMR (>0.5) contributed to decreases in ED visits in the subsequent 12 months only among African Americans (OR = 0.551, 95% CI 0.364-0.832) and Hispanics (OR = 0.613, 95% CI 0.489-0.770). No association between AMR and hospitalizations was found.
Our findings indicate that increased use of controller medication contributes to a decrease in ED visits among African American and Hispanic children with persistent asthma. Increased use of controller medications and caregiver\'s efforts for medication adherence may contribute to a reduction in asthma disparities.
摘要：
未经证实：非洲裔美国人和西班牙裔儿童因哮喘就诊和住院的比率较高可能表明哮喘管理欠佳，导致更大的医疗保健经济负担。尚不清楚种族/种族与控制者药物和基于医院的护理利用是否存在关联。
UNASSIGNED：本研究检查哮喘药物治疗比率(AMR)是否可预测种族/民族哮喘的医疗保健利用率。
UNASSIGNED：在洛杉矶确定了4,584名患有持续性哮喘的Medi-Cal儿童（5-11岁），并根据HEDIS标准计算了其AMR（2018年）。使用了医疗保健利用率数据，包括住院,ED访问，和药房声称检查更高的AMR是否预示着在随后的3,6和12个月（2019年）内按种族/种族划分的医疗保健利用率下降。
未经评估：非洲裔美国儿童的平均AMR最低（0.401）。在接下来的12个月里,他们在ED就诊次数(0.249)和住院次数(0.121)中最高，但门诊次数最低（0.793）。逻辑回归结果显示，AMR值较高（>0.5）仅在非洲裔美国人（OR=0.551，95％CI0.364-0.832）和西班牙裔美国人（OR=0.613，95％CI0.489-0.770）中导致随后12个月的ED访视减少。没有发现AMR和住院之间的关联。
UNASSIGNED：我们的研究结果表明，在患有持续性哮喘的非洲裔美国人和西班牙裔儿童中，增加使用控制药物有助于减少ED就诊。增加控制药物的使用和护理人员对药物依从性的努力可能有助于减少哮喘差异。
UNASSIGNED：本研究检查哮喘药物治疗比率(AMR)是否可预测种族/民族哮喘的医疗保健利用率。
UNASSIGNED：在洛杉矶确定了4,584名患有持续性哮喘的Medi-Cal儿童（5-11岁），并根据HEDIS标准计算了其AMR（2018年）。使用了医疗保健利用率数据，包括住院,ED访问，和药房声称检查更高的AMR是否预示着在随后的3,6和12个月（2019年）内按种族/种族划分的医疗保健利用率下降。
未经评估：非洲裔美国儿童的平均AMR最低（0.401）。在接下来的12个月里,他们在ED就诊次数(0.249)和住院次数(0.121)中最高，但门诊次数最低（0.793）。逻辑回归结果显示，AMR值较高（>0.5）仅在非洲裔美国人（OR=0.551，95％CI0.364-0.832）和西班牙裔美国人（OR=0.613，95％CI0.489-0.770）中导致随后12个月的ED访视减少。没有发现AMR和住院之间的关联。
UNASSIGNED：我们的研究结果表明，在患有持续性哮喘的非洲裔美国人和西班牙裔儿童中，增加使用控制药物有助于减少ED就诊。增加控制药物的使用和护理人员对药物依从性的努力可能有助于减少哮喘差异。
