137 lines
4.1 KiB
YAML
137 lines
4.1 KiB
YAML
|
abstract: 'BACKGROUND AND OBJECTIVES: Health care reform offers a new opportunity
|
||
|
|
||
|
to address child health disparities. This study sought to characterize
|
||
|
|
||
|
racial differences in pediatric asthma readmissions with a focus on the
|
||
|
|
||
|
potential explanatory role of hardships that might be addressed in
|
||
|
|
||
|
future patient care models.
|
||
|
|
||
|
METHODS: We enrolled 774 children, aged 1 to 16 years, admitted for
|
||
|
|
||
|
asthma or bronchodilator-responsive wheezing in a population-based
|
||
|
|
||
|
prospective observational cohort. The outcome was time to readmission.
|
||
|
|
||
|
Child race, socioeconomic status (measured by lower income and caregiver
|
||
|
|
||
|
educational attainment), and hardship (caregivers looking for work,
|
||
|
|
||
|
having no one to borrow money from, not owning a car or home, and being
|
||
|
|
||
|
single/never married) were recorded. Analyses used Cox proportional
|
||
|
|
||
|
hazards.
|
||
|
|
||
|
RESULTS: The cohort was 57\% African American, 33\% white, and 10\%
|
||
|
|
||
|
multiracial/other; 19\% were readmitted within 12 months. After
|
||
|
|
||
|
adjustment for asthma severity classification, African Americans were
|
||
|
|
||
|
twice as likely to be readmitted as whites (hazard ratio: 1.98; 95\%
|
||
|
|
||
|
confidence interval: 1.42 to 2.77). Compared with whites, African
|
||
|
|
||
|
American caregivers were significantly more likely to report lower
|
||
|
|
||
|
income and educational attainment, difficulty finding work, having no
|
||
|
|
||
|
one to borrow money from, not owning a car or home, and being
|
||
|
|
||
|
single/never married (all P <= .01). Hardships explained 41\% of the
|
||
|
|
||
|
observed racial disparity in readmission; jointly, socioeconomic status
|
||
|
|
||
|
and hardship explained 49\%.
|
||
|
|
||
|
CONCLUSIONS: African American children were twice as likely to be
|
||
|
|
||
|
readmitted as white children; hardships explained > 40\% of this
|
||
|
|
||
|
disparity. Additional factors (eg, pollution, tobacco exposure, housing
|
||
|
|
||
|
quality) may explain residual disparities. Targeted interventions could
|
||
|
|
||
|
help achieve greater child health equity.'
|
||
|
affiliation: 'Beck, AF (Corresponding Author), 3333 Burnet Ave,ML 7035, Cincinnati,
|
||
|
OH 45229 USA.
|
||
|
|
||
|
Beck, Andrew F.; Sauers, Hadley S.; Newman, Nicholas C.; Kahn, Robert S., Cincinnati
|
||
|
Childrens Hosp Med Ctr, Div Gen \& Community Pediat, Cincinnati, OH 45229 USA.
|
||
|
|
||
|
Beck, Andrew F.; Simmons, Jeffrey M.; Sauers, Hadley S., Cincinnati Childrens Hosp
|
||
|
Med Ctr, Div Hosp Med, Cincinnati, OH 45229 USA.
|
||
|
|
||
|
Moncrief, Terri, Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Div Allergy \&
|
||
|
Immunol, Cincinnati, OH 45229 USA.
|
||
|
|
||
|
Huang, Bin; Chen, Chen; Ryan, Patrick H., Cincinnati Childrens Hosp Med Ctr, Dept
|
||
|
Pediat, Div Biostat \& Epidemiol, Cincinnati, OH 45229 USA.'
|
||
|
author: Beck, Andrew F. and Huang, Bin and Simmons, Jeffrey M. and Moncrief, Terri
|
||
|
and Sauers, Hadley S. and Chen, Chen and Ryan, Patrick H. and Newman, Nicholas C.
|
||
|
and Kahn, Robert S.
|
||
|
author-email: andrew.beck1@cchmc.org
|
||
|
author_list:
|
||
|
- family: Beck
|
||
|
given: Andrew F.
|
||
|
- family: Huang
|
||
|
given: Bin
|
||
|
- family: Simmons
|
||
|
given: Jeffrey M.
|
||
|
- family: Moncrief
|
||
|
given: Terri
|
||
|
- family: Sauers
|
||
|
given: Hadley S.
|
||
|
- family: Chen
|
||
|
given: Chen
|
||
|
- family: Ryan
|
||
|
given: Patrick H.
|
||
|
- family: Newman
|
||
|
given: Nicholas C.
|
||
|
- family: Kahn
|
||
|
given: Robert S.
|
||
|
da: '2023-09-28'
|
||
|
doi: 10.1542/peds.2013-2437
|
||
|
eissn: 1098-4275
|
||
|
files: []
|
||
|
issn: 0031-4005
|
||
|
journal: PEDIATRICS
|
||
|
keywords: childhood asthma; readmissions; racial disparities; pediatrics
|
||
|
keywords-plus: 'HEALTH-CARE; HOSPITAL READMISSIONS; CHILDHOOD ASTHMA; UNITED-STATES;
|
||
|
|
||
|
CHILDREN; POPULATION; OUTCOMES; QUALITY; RISK; DETERMINANTS'
|
||
|
language: English
|
||
|
month: MAR
|
||
|
number: '3'
|
||
|
number-of-cited-references: '54'
|
||
|
orcid-numbers: 'Huang, Bin/0000-0001-9724-675X
|
||
|
|
||
|
Newman, Nicholas/0000-0003-1963-4006
|
||
|
|
||
|
Sauers-Ford, Hadley/0000-0002-7218-2953'
|
||
|
pages: 431-439
|
||
|
papis_id: 43fca090b8abe72f61a8aa1c5f90bbbe
|
||
|
ref: Beck2014rolefinancial
|
||
|
researcherid-numbers: 'Ryan, Patrick/HDO-1133-2022
|
||
|
|
||
|
Ryan, Patrick H/L-7062-2015
|
||
|
|
||
|
Huang, Bin/G-2468-2014
|
||
|
|
||
|
Huang, Bin/U-2867-2019
|
||
|
|
||
|
Newman, Nicholas/J-9066-2019
|
||
|
|
||
|
'
|
||
|
times-cited: '117'
|
||
|
title: Role of Financial and Social Hardships in Asthma Racial Disparities
|
||
|
type: Article
|
||
|
unique-id: WOS:000335330700010
|
||
|
usage-count-last-180-days: '0'
|
||
|
usage-count-since-2013: '33'
|
||
|
volume: '133'
|
||
|
web-of-science-categories: Pediatrics
|
||
|
year: '2014'
|