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  1. Quality of care for preschool children with asthma : the role of social factors and practice setting.

    Article - En anglais

    Objective

    To determine whether patient race or source of payment is associated with differences in the quality of inpatient and outpatient treatment for young children with asthma.

    Design

    Structured medical record review.

    Setting

    Tertiary care pediatric hospital.

    Patients

    We studied 354 patients aged 1 to 6 years discharged with asthma between October 1,1989 and September 30,1990.

    Measures

    We developed indicators of the quality of asthma care provided before and during hospitalization and planned after discharge.

    Outpatient indicators were the use of inhaled beta-agonists and the use of preventive anti-inflammatory medications (inhaled steroids or cromolyn sodium) before admission.

    In-hospital indicators were the intensity of inhaled beta-agonist therapy in the emergency department and length of stay.

    Planning for post-hospital care was assessed by the prescription of a nebulizer for home use.

    We examined associations between these indicators and patient race and source of payment, and explored the influence of primary-care practice type on these associations.

    Results

    After adjustment for potential confounders, we found that Hispanic patients were less likely than white patients to have taken inhaled beta-agonists before admission.

    Both black and Hispanic patients were less likely than white patients to have taken anti-inflammatory medications.

    Mots-clés Pascal : Asthme, Enfant, Homme, Nourrisson, Evaluation, Qualité, Soin, Etats Unis, Amérique du Nord, Amérique, Ethnie, Etude comparative, Assurance maladie, Economie santé, Appareil respiratoire pathologie, Bronchopneumopathie obstructive

    Mots-clés Pascal anglais : Asthma, Child, Human, Infant, Evaluation, Quality, Care, United States, North America, America, Ethnic group, Comparative study, Health insurance, Health economy, Respiratory disease, Obstructive pulmonary disease

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0210305

    Code Inist : 002B11B. Création : 09/06/1995.