2023-09-28 14:46:10 +00:00
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abstract: 'BACKGROUND AND OBJECTIVES: Health care reform offers a new opportunity
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to address child health disparities. This study sought to characterize
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racial differences in pediatric asthma readmissions with a focus on the
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potential explanatory role of hardships that might be addressed in
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future patient care models.
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METHODS: We enrolled 774 children, aged 1 to 16 years, admitted for
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asthma or bronchodilator-responsive wheezing in a population-based
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prospective observational cohort. The outcome was time to readmission.
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Child race, socioeconomic status (measured by lower income and caregiver
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educational attainment), and hardship (caregivers looking for work,
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having no one to borrow money from, not owning a car or home, and being
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single/never married) were recorded. Analyses used Cox proportional
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hazards.
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RESULTS: The cohort was 57\% African American, 33\% white, and 10\%
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multiracial/other; 19\% were readmitted within 12 months. After
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adjustment for asthma severity classification, African Americans were
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twice as likely to be readmitted as whites (hazard ratio: 1.98; 95\%
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confidence interval: 1.42 to 2.77). Compared with whites, African
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American caregivers were significantly more likely to report lower
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income and educational attainment, difficulty finding work, having no
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one to borrow money from, not owning a car or home, and being
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single/never married (all P <= .01). Hardships explained 41\% of the
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observed racial disparity in readmission; jointly, socioeconomic status
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and hardship explained 49\%.
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CONCLUSIONS: African American children were twice as likely to be
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readmitted as white children; hardships explained > 40\% of this
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disparity. Additional factors (eg, pollution, tobacco exposure, housing
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quality) may explain residual disparities. Targeted interventions could
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help achieve greater child health equity.'
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affiliation: 'Beck, AF (Corresponding Author), 3333 Burnet Ave,ML 7035, Cincinnati,
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OH 45229 USA.
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Beck, Andrew F.; Sauers, Hadley S.; Newman, Nicholas C.; Kahn, Robert S., Cincinnati
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Childrens Hosp Med Ctr, Div Gen \& Community Pediat, Cincinnati, OH 45229 USA.
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Beck, Andrew F.; Simmons, Jeffrey M.; Sauers, Hadley S., Cincinnati Childrens Hosp
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Med Ctr, Div Hosp Med, Cincinnati, OH 45229 USA.
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Moncrief, Terri, Cincinnati Childrens Hosp Med Ctr, Dept Pediat, Div Allergy \&
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Immunol, Cincinnati, OH 45229 USA.
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Huang, Bin; Chen, Chen; Ryan, Patrick H., Cincinnati Childrens Hosp Med Ctr, Dept
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Pediat, Div Biostat \& Epidemiol, Cincinnati, OH 45229 USA.'
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author: Beck, Andrew F. and Huang, Bin and Simmons, Jeffrey M. and Moncrief, Terri
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and Sauers, Hadley S. and Chen, Chen and Ryan, Patrick H. and Newman, Nicholas C.
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and Kahn, Robert S.
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author-email: andrew.beck1@cchmc.org
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author_list:
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- family: Beck
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given: Andrew F.
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- family: Huang
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given: Bin
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- family: Simmons
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given: Jeffrey M.
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- family: Moncrief
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given: Terri
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- family: Sauers
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given: Hadley S.
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- family: Chen
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given: Chen
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- family: Ryan
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given: Patrick H.
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- family: Newman
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given: Nicholas C.
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- family: Kahn
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given: Robert S.
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da: '2023-09-28'
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doi: 10.1542/peds.2013-2437
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eissn: 1098-4275
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files: []
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issn: 0031-4005
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journal: PEDIATRICS
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keywords: childhood asthma; readmissions; racial disparities; pediatrics
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keywords-plus: 'HEALTH-CARE; HOSPITAL READMISSIONS; CHILDHOOD ASTHMA; UNITED-STATES;
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CHILDREN; POPULATION; OUTCOMES; QUALITY; RISK; DETERMINANTS'
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language: English
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month: MAR
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number: '3'
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number-of-cited-references: '54'
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orcid-numbers: 'Huang, Bin/0000-0001-9724-675X
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Newman, Nicholas/0000-0003-1963-4006
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Sauers-Ford, Hadley/0000-0002-7218-2953'
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pages: 431-439
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papis_id: 43fca090b8abe72f61a8aa1c5f90bbbe
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ref: Beck2014rolefinancial
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researcherid-numbers: 'Ryan, Patrick/HDO-1133-2022
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Ryan, Patrick H/L-7062-2015
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Huang, Bin/G-2468-2014
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Huang, Bin/U-2867-2019
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Newman, Nicholas/J-9066-2019
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'
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times-cited: '117'
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title: Role of Financial and Social Hardships in Asthma Racial Disparities
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000335330700010
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usage-count-last-180-days: '0'
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usage-count-since-2013: '33'
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volume: '133'
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web-of-science-categories: Pediatrics
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year: '2014'
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