Asthma-related healthcare services utilization by African-Americans enrolled in West Virginia Medicaid.
BACKGROUND
Over the past 25 years, African-Americans have experienced higher rates of emergency department (ED) visits, hospitalizations, and death due to asthma compared to other ethnic groups in the US. African-Americans of lower socioeconomic groups are particularly vulnerable to asthma morbidity and mortality. Few studies have investigated asthma-related healthcare services use by different age and gender groups within this sub-population.


OBJECTIVE
The objectives of this study are to: (1) report rates of asthma among African-Americans who receive healthcare through a state government Medicaid program that provides medical coverage to low-income citizens; (2) report rates of asthma-related medical services and prescription utilization for these recipients; and (3) report the costs to the Medicaid program for asthma-related care for these recipients.


METHODS
This was a cross-sectional descriptive analysis. West Virginia (WV) Medicaid administrative fee-for-service claims data from calendar year 2002 were the data source. Medical services claims with a primary diagnosis of asthma for recipients who were African-American less than 65 years of age were extracted. Matching prescription claims for these recipients for medications to treat asthma were extracted. Dollars reimbursed for medical services and prescription medications were from the perspective of WV Medicaid.


RESULTS
There were 635 African-American recipients who had a primary diagnosis of asthma. Children under 21 years of age comprised the majority of the sample. Males under 21 years of age, and females 21 years and older had the highest rates of asthma. Although males 21 years and older accounted for the lowest proportion of age-gender groups, these recipients had the highest rates of hospitalizations and ED visits for asthma. Less than one-third of the recipients had a prescription claim for an inhaled corticosteroid. There were more claims paid by Medicaid for quick-relief medications vs. controller pharmacotherapy for the sample. A majority of the dollars paid by Medicaid for asthma care were for prescriptions and hospitalizations.


CONCLUSIONS
Asthma prevalence and asthma-related medical services utilization rates among African-American recipients of Medicaid varied by age and gender groups. These recipients appeared to be underutilizing controller pharmacotherapy for asthma.
Department of Pharmaceutical Systems and Policy, West Virginia University, Morgantown, WV 26506, USA. vpawar@hsc.wvu.edu
Vivek
V
Pawar
Michael James
MJ
Smith
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D017677:Age Distribution; D001249:Asthma / Q000191:economics / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000191:economics / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008484:Medicaid / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D011203:Poverty; D012189:Retrospective Studies; D017678:Sex Distribution; D014903:West Virginia