Dataset Information

Racial and ethnic differences in health care utilization for childhood eczema: An analysis of the 2001-2013 Medical Expenditure Panel Surveys.

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.

SUBMITTER: Fischer AH

PROVIDER: S-EPMC5916760 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Racial and ethnic differences in health care utilization for childhood eczema: An analysis of the 2001-2013 Medical Expenditure Panel Surveys.

Fischer Alexander H AH Shin Daniel B DB Margolis David J DJ Takeshita Junko J

Journal of the American Academy of Dermatology 20170928 6

<h4>Background</h4>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.<h4>Objective</h4>To evaluate health care utilization for childhood eczema among different racial/ethnic groups in the United States.<h4>Methods</h4>We performed a cohort study of non-Hispanic white (reference), non-Hispanic black, a ...[more]

PMID: 28964540

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Project description:OBJECTIVES:The prevalence of childhood obesity is significantly higher among racial and/or ethnic minority children in the United States. It is unclear to what extent well-established obesity risk factors in infancy and preschool explain these disparities. Our objective was to decompose racial and/or ethnic disparities in children's weight status according to contributing socioeconomic and behavioral risk factors. METHODS:We used nationally representative data from ?10?700 children in the Early Childhood Longitudinal Study Birth Cohort who were followed from age 9 months through kindergarten entry. We assessed the contribution of socioeconomic factors and maternal, infancy, and early childhood obesity risk factors to racial and/or ethnic disparities in children's BMI z scores by using Blinder-Oaxaca decomposition analyses. RESULTS:The prevalence of risk factors varied significantly by race and/or ethnicity. African American children had the highest prevalence of risk factors, whereas Asian children had the lowest prevalence. The major contributor to the BMI z score gap was the rate of infant weight gain during the first 9 months of life, which was a strong predictor of BMI z score at kindergarten entry. The rate of infant weight gain accounted for between 14.9% and 70.5% of explained disparities between white children and their racial and/or ethnic minority peers. Gaps in socioeconomic status were another important contributor that explained disparities, especially those between white and Hispanic children. Early childhood risk factors, such as fruit and vegetable consumption and television viewing, played less important roles in explaining racial and/or ethnic differences in children's BMI z scores. CONCLUSIONS:Differences in rapid infant weight gain contribute substantially to racial and/or ethnic disparities in obesity during early childhood. Interventions implemented early in life to target this risk factor could help curb widening racial and/or ethnic disparities in early childhood obesity.

Project description:BackgroundPrevious work has demonstrated racial/ethnic differences in emergency department (ED) utilization, but less is known about racial/ethnic differences in the experience of care received during an ED visit.ObjectiveTo examine differences in self-reported healthcare utilization and experiences with ED care by patients' race/ethnicity.DesignAdult ED patients discharged to community (DTC) were surveyed (response rate: 20.25%) using the Emergency Department Patient Experience of Care (EDPEC) DTC Survey. Linear regression was used to estimate case-mix-adjusted differences in patient experience between racial/ethnic groups.Participants3122 survey respondents who were discharged from the EDs of 50 hospitals nationwide January-March 2016.Main measuresSix measures: getting timely care, doctor and nurse communication, communication about medications, receipt of sufficient information about test results, whether hospital staff discussed the patient's ability to receive follow-up care, and willingness to recommend the ED.Key resultsBlack and Hispanic patients were significantly more likely than White patients to report visiting the ED for an ongoing health condition (40% Black, 30% Hispanic, 28% White, p<0.001), report having visited an ED 3+ times in the last 6 months (26% Black, 25% Hispanic, 19% White, p<0.001), and report not having a usual source of care (19% Black, 19% Hispanic, 8% White, p<0.001). Compared with White patients, Hispanic patients more often reported that hospital staff talked with them about their ability to receive needed follow-up care (+7.2 percentile points, p=0.038) and recommended the ED (+7.2 points, p=0.037); Hispanic and Black patients reported better doctor and nurse communication (+6.4 points, p=0.008; +4 points, p=0.036, respectively).ConclusionsHispanic and Black ED patients reported higher ED utilization, lacked a usual source of care, and reported better experience with ED care than White patients. Results may reflect differences in care delivery by staff and/or different expectations of ED care among Hispanic and Black patients.

Dataset Information

Racial and ethnic differences in health care utilization for childhood eczema: An analysis of the 2001-2013 Medical Expenditure Panel Surveys.

Publications

Racial and ethnic differences in health care utilization for childhood eczema: An analysis of the 2001-2013 Medical Expenditure Panel Surveys.

Similar Datasets

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