The Role of Access: Acute Asthma Care Utilization in a 2008 Arizona Medicaid Population

Abstract

Prior research shows racial disparities in patient (IP) and emergency department (ED) use for children with asthma. It has been difficult to disentangle the effects of race/ethnicity from the effect of socioeconomic status on IP and ED use. To better understand the relationship between race/ethnicity and care in these settings, data from a cohort of 3490 school-age children with asthma enrolled in the AHCCCS (Medicaid) program in Maricopa County, Arizona in 2008 were analyzed. For children with asthma, odds ratios were estimated by comparing ‘any visit’ (ED or IP) to ‘no visits’ according to race/ethnicity. Among children with asthma, junior high and high school individuals were more likely to experience a visit compared to elementary school age individuals. African-Americans were about twice as likely to have at least one ED or IP visit compared with White, non-Hispanics. Odds ratios for having any ED or IP visit were also increased in Hispanics and Native-Americans compared with White, non-Hispanics but the increases were not statistically significant. Although the generalizability of the study is limited, the data suggest that differences in socioeconomic status do not fully explain racial disparities in use of the ED and IP settings for asthma care. Attempts 5 to further understand any causal relationship between race/ethnicity and asthma should be coupled with targeted interventions to minimize known disparities.