ArticleThe Journal of asthma : official journal of the Association for the Care of Asthma2017
Individual and county level predictors of asthma related emergency department visits among children on Medicaid: A multilevel approach.
Article in The Journal of asthma : official journal of the Association for the Care of Asthma, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Children with poorly controlled asthma: Randomized controlled trial of a home-based environmental control intervention.Pediatric pulmonology · 2019Trial
- The Role of Neighborhood Air Pollution in Disparate Racial and Ethnic Asthma Acute Care Use.American journal of respiratory and critical care medicine · 2024Article
- Assessing asthma self-management education among US children with current asthma, Asthma Call-back Survey (ACBS) 2015-2017.The Journal of asthma : official journal of the Association for the Care of Asthma · 2023Article
- Socioeconomic and environmental determinants of asthma prevalence: a cross-sectional study at the U.S. County level using geographically weighted random forests.International journal of health geographics · 2023Article
- Road traffic density and recurrent asthma emergency department visits among Medicaid enrollees in New York State 2005-2015.Environmental health : a global access science source · 2022Article
- Social Determinants of Emergency Department Visits in Mild Compared to Moderate and Severe Asthma.Lung · 2022Article
- Adjusting for Social Risk Factors in Pediatric Quality Measures: Adding to the Evidence Base.Academic pediatrics · 2022Article
- Effects of forced disruption in Medicaid managed care on children with asthma.Health services research · 2021Article
- Cost barriers to asthma care by health insurance type among children with asthma.The Journal of asthma : official journal of the Association for the Care of Asthma · 2020Article
- Health Care Disparities in Race-Ethnic Minority Communities and Populations: Does the Availability of Health Care Providers Play a Role?Journal of racial and ethnic health disparities · 2020Article
- Improved asthma outcomes observed in the vicinity of coal power plant retirement, retrofit, and conversion to natural gas.Nature energy · 2020Article
- Dose, Timing, and Type of Infant Antibiotic Use and the Risk of Childhood Asthma.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Racial disparities in asthma-related health care use in the National Heart, Lung, and Blood Institute's Severe Asthma Research Program.The Journal of allergy and clinical immunology · 2019Article
- A Mixed Methods Approach to Evaluate Partnerships and Implementation of the Massachusetts Prevention and Wellness Trust Fund.Frontiers in public health · 2018Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectiveDisparities in asthma outcomes are well documented in the United States. Interventions to promote equity in asthma outcomes could target factors at the individual and community levels. The objective of this analysis was to understand the effect of individual (race, gender, age, and preventive inhaler use) and county-level factors (demographic, socioeconomic, health care, air-quality) on asthma emergency department (ED) visits among Medicaid-enrolled children. This was a retrospective cohort study of Medicaid-enrolled children with asthma in 29 states in 2009. Multilevel regression models of asthma ED visits were constructed utilizing individual-level variables (race, gender, age, and preventive inhaler use) from the Medicaid enrollment file and county-level variables reflecting population and health system characteristics from the Area Resource File (ARF). County-level measures of air quality were obtained from Environmental Protection Agency (EPA) data.
resultsThe primary modifiable risk factor at the individual level was found to be the ratio of long-term controller medications to total asthma medications. County-level factors accounted for roughly 6% of the variance in the asthma ED visit risk. Increasing county-level racial segregation (OR=1.04, 95% CI=1.01-1.08) was associated with increasing risk of asthma ED visits. Greater supply of pulmonary physicians at the county level (OR=0.81, 95% CI=0.68-0.97) was associated with a reduction in risk of asthma ED visits.
conclusionsAt the patient care level, proper use of controller medications is the factor most amenable to intervention. There is also a societal imperative to address negative social determinants, such as residential segregation.
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