Racial and ethnic differences in health care utilization for childhood eczema: An analysis of the 2001-2013 Medical Expenditure Panel Surveys - 23/11/17
Abstract |
Background |
Eczema is a common chronic inflammatory disease of the skin. Studies suggest differences in disease prevalence and severity by race/ethnicity. Our knowledge of health care utilization for eczema among different racial/ethnic groups remains limited.
Objective |
To evaluate health care utilization for childhood eczema among different racial/ethnic groups in the United States.
Methods |
We performed a cohort study of non-Hispanic white (reference), non-Hispanic black, and Hispanic white individuals under the age of 18 years with caregiver-reported eczema (N = 2043) pooled from the 2-year longitudinal cohorts of the 2001-2013 Medical Expenditure Panel Surveys. Health care utilization outcomes were evaluated over the 2-year follow-up period by race/ethnicity using multivariable regression.
Results |
Among all children with eczema, non-Hispanic blacks were less likely than whites to report an ambulatory visit for eczema (adjusted odds ratio [ORadj] 0.69; 95% confidence interval [CI] 0.51-0.92). Among those with ≥1 ambulatory visit for eczema, non-Hispanic blacks reported more visits (adjusted incidence rate ratio [IRRadj] 1.68; 95% CI 1.10-2.55) and prescriptions (IRRadj 1.22; 95% CI 1.01-1.46) than whites and were more likely than whites to report a dermatology visit (ORadj 1.82; 95% CI 1.06-3.14) for eczema.
Limitations |
We used caregiver- or self-reported data.
Conclusion |
Our findings suggest disparities in health care utilization for eczema among non-Hispanic black children despite utilization patterns suggestive of more severe disease.
Le texte complet de cet article est disponible en PDF.Key words : ambulatory visits, atopic dermatitis, eczema, ethnicity, health care disparities, health care utilization, prescriptions, race
Abbreviations used : CI, ICD-9-CM, MEPS, OR, IRR
Plan
Funding sources: Dr Takeshita is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases through grant K23-AR068433. |
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Conflicts of interest: Dr Margolis has served as a consultant for Sanofi and GlaxoSmithKline, receiving honoraria, and has received a research grant (to the Trustees of the University of Pennsylvania) from Valeant. Dr Takeshita has received a research grant from Pfizer Inc (to the Trustees of the University of Pennsylvania) and payment for continuing medical education work related to psoriasis that was supported indirectly by Eli Lilly. All other authors have no conflicts of interest to report. |
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Previously presented: Results were presented in part at the Society for Investigative Dermatology 2017 annual meeting in Portland, Oregon, April 26-29, 2017. |
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Reprints not available from the authors. |
Vol 77 - N° 6
P. 1060-1067 - décembre 2017 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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