The objective of this study was to determine whether racial differences in patterns of asthma care persist in a healthcare environment when financial barriers to health care are minimized.
The study cohort consisted of African-American (AA) and Caucasian (C) patients, 18-50 years old, enrolled in a large HMO and hospitalized for asthma in 1993-1995.
Baseline and 1-year follow-up data were collected from the HMO computerized database.
Of the 193 patients in the cohort, 124 (65.3%) were AA and 67 (34.7%) were C. AAs were younger (mean=36.2, SD=9.9) than Cs (mean=39.4, SD=9.1), had a lower median household income, and made more asthma-related emergency department (ED) visits (45.2%) than Cs (22.4%) during the 1 year after the initial hospitalization (all p values<0.001).
During the same time period, Cs made more asthma-related primary care (70.2%) and allergy/pulmonary visits (38.8%) than AAs (47.6% rind 27%, respectively).
Although there were no significant racial differences in the rehospitalization rate, AA Medicaid contract patients (32%) had more rehospitalizations for asthma than AA regular contract patients (15.8%). These differential patterns in the use of asthma-related healthcare in this study indicate that the provision of health insurance alone is not sufficient to promote optimal levels of asthma management by all beneficiaries.
Asthma education programs targeted for low-income AA patients may improve inappropriate healthcare use patterns.
Mots-clés Pascal : Asthme, Soin, Santé, Assurance maladie, Revenu individuel, Caucasoïde, Traitement, Homme, Race, Négroïde, Appareil respiratoire pathologie, Bronchopneumopathie obstructive
Mots-clés Pascal anglais : Asthma, Care, Health, Health insurance, Personal income, Caucasoid, Treatment, Human, Race, Negroid, Respiratory disease, Obstructive pulmonary disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0254206
Code Inist : 002B11B. Création : 16/11/1999.