Higher health care consumption associated with ethnicity in children with asthma
Paediatric lung disease: from mechanisms to therapy (English)Background
Asthma is the most common chronic disease in childhood leading to high health care utilization and socioeconomic burden (Masoli M. et al. Allergy 2004).
Aims and objectives
To assess whether social characteristicsare associated with the frequency of health care utilization of pediatric asthma patients in the Netherlands.
For this cross-sectional analysis we used data from the PACMAN-study, a community pharmacy-based cohort of Dutch children with regular use of asthma medication. Parental reported health care consumption for asthma in the past year was assessed based on visits to the general practitioner, pediatrician, pulmonologist and emergency room. Frequent visits were defined as ≥ twice per year. Demography (ethnicity, age), socio-economic data, asthma control, family health history and medication use were considered as factors potentially influencing health care use. Regression analyses were used to investigate relevant associations while adjusting for potential confounders.
In total, 959 children (62% male, age 8.4 ± 2.4 years, 73.6% with Dutch ethnicity) were included in the analysis. 43% of the children had frequent visits to the general practitioner, 23.4% to the pediatrician, 8.3% to the pulmonologist and 2.9% to the emergency room.
Younger age of the child and ethnicity (non-Dutch background) were independently associated with frequent visits to the general practitioner (OR 1.64; CI 1.19-2.27), to the pediatrician (OR 1.58;CI 1.10-2.28) and to the pulmonologist (OR1.88; CI 1.12 - 3.16). A lower degree of maternal education (OR 3.91; CI 1.54 – 9.88) and younger age of the child were associated with more emergency room visits.
Differences in age, ethnicity and maternal education increased asthma-related health care utilization. A more personalized treatment plan tailored tot specific populations might help in optimizing care and reducing costs.