The Association of Health Insurance and Disease Impairment With Reported Asthma Prevalence in U.S. Children

Details

• Alternative Title:
  Health Serv Res
• Personal Author:
  Coker, Tumaini R. ; Kaplan, Robert M. ; Chung, Paul J.
• Description:
  Objective
  
  To test the hypotheses that reported asthma prevalence is higher among insured than uninsured children and that insurance-based differences in asthma diagnosis, treatment, and healthcare utilization are associated with disease severity.
  
  Data Sources
  
  National Health and Nutrition Examination Survey, 2003–2008.
  
  Study Design
  
  We used multivariate logistic regression to examine the relationship between insurance and asthma symptom severity with asthma diagnosis, treatment, and acute care utilization.
  
  Principal Findings
  
  In multivariate analysis, insured children had greater odds of reporting a current diagnosis of asthma than uninsured children (Odds Ratio [OR]=2.08, 95% Confidence Interval [CI] 1.47–2.94). When interactions between insurance and asthma impairment were included, insurance was associated with greater odds of diagnosis among children with intermittent (OR=4.08, 95%CI 1.57–10.61), but not persistent, symptoms. Among children with intermittent symptoms, insurance was associated with inhaled corticosteroid use (OR=4.51, 95%CI 1.18–17.24) and asthma-related acute care utilization (OR=5.21, 95%CI 1.21–23.53); these associations were non-significant among children with persistent symptoms.
  
  Conclusion
  
  Being insured increases only the likelihood that a child with intermittent, not persistent, asthma symptoms will receive an asthma diagnosis and control medication, and may not reduce acute care utilization. Although universal insurance may increase detection and management of undiagnosed childhood asthma, theorized cost savings from reduced acute care utilization might not materialize.
  
  
• Subjects:
  Adolescent Adrenal Cortex Hormones Bronchodilator Agents Child Child, Preschool Female Health Services Humans Infant Insurance, Health Insurance Coverage Male Nutrition Surveys Outcome Assessment (Health Care) Prevalence Severity Of Illness Index Socioeconomic Factors

  More +
• Source:
  Health Serv Res. 47(1 Pt 2):431-445.
• Pubmed ID:
  22091849
• Pubmed Central ID:
  PMC3258307
• Document Type:
  Journal Article
• Funding:
  RC2 HL101811-01/HL/NHLBI NIH HHS/United States ; RC2HL101811-01/HL/NHLBI NIH HHS/United States ; U48 DP000056-04/DP/NCCDPHP CDC HHS/United States
• Place as Subject:
  United States
• Volume:
  47
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:05e25a5b88fc995f443a10905d6ae8a4027b02116fe08a8a358ea9f8e2ac1a10
• Download URL:
  https://stacks.cdc.gov/view/cdc/33295/cdc_33295_DS1.pdf
• File Type:
  [PDF - 296.17 KB ]