Are minority children the last to benefit from a new technology? Technology diffusion and inhaled corticosteriods for asthma.
BACKGROUND
Racial and ethnic disparities in health and health care have been well documented, but few studies have addressed how disparities may change over time.


OBJECTIVE
We sought to determine the change in relative rates over time of corticosteroid metered dose inhaler (MDI) use in minority and nonminority populations with asthma.


METHODS
We used a cross-sectional survey for 5 periods of 2 years' each (1989-1990, 1991-1992, 1993-1994, 1995-1996, 1997-1998) using the National Ambulatory Medical Care Surveys (NAMCS).


METHODS
A total of 3671 visits by adults and children with asthma to U.S. office-based physicians comprised our sample.


METHODS
We sought to measure differences in inhaled corticosteroid use for minority and nonminority adults and children controlling for gender, specialty, U.S. region, and type of insurance.


RESULTS
Minority patients with asthma were less than half as likely as nonminority patients to have had a steroid MDI prescribed during 1989-1990. By 1995-1996, minority and nonminority patients with asthma were equally likely to have had a steroid MDI prescribed. Although differences between black and white patients resolved, differences between white and Hispanic patients persisted even after adjusting for insurance. Children initially were less likely than adults with asthma to have steroid MDI prescribed, and this difference persisted. Minority children had the greatest delay in adoption of steroid MDIs.


CONCLUSIONS
Steroid MDIs diffused into minority and nonminority adult and child populations at different rates.
Ferris
Timothy G
TG
Institute for Health Policy, Massachusetts General Hospital, Partners HealthCare System, and Harvard Medical School, Boston, Massachusetts 02114, USA. tferris@partners.org
Kuhlthau
Karen
K
Ausiello
John
J
Perrin
James
J
Kahn
Robert
R
D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D001741:Black or African American; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003625:Data Collection; D004059:Diffusion of Innovation; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D036501:Metered Dose Inhalers / Q000706:statistics & numerical data*; D008875:Middle Aged; D008913:Minority Groups; D014481:United States; D044465:White People
D000305:Adrenal Cortex Hormones