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

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:77

Article

Fischer, Alexander H.¹  Shin, Daniel B.²  Margolis, David J.^2,3  Takeshita, Junko^2,3 

[1] Johns Hopkins Univ, Sch Med, Dept Dermatol, Baltimore, MD 21205 USA

[2] Univ Penn, Dept Dermatol, Perelman Sch Med, 3400 Civ Ctr Blvd,7th Floor,South Tower,Off 728, Philadelphia, PA 19104 USA

[3] Univ Penn, Dept Biostat Epidemiol & Informat, Ctr Clin Epidemiol & Biostat, Perelman Sch Med, 3400 Civ Ctr Blvd,7th Floor,South Tower,Off 728, Philadelphia, PA 19104 USA

关键词: ambulatory visits;    atopic dermatitis;    eczema;    ethnicity;    health care disparities;    health care utilization;    prescriptions;    race;   

DOI  :  10.1016/j.jaad.2017.08.035

来源: Elsevier

【 摘 要 】

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.

【 授权许可】

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