Racial differences in the use of respiratory medications in premature infants after discharge from the neonatal intensive care unit.
OBJECTIVE
To determine the effect of race and ethnicity on the use of oral beta-agonists, inhaled beta-agonists, and inhaled corticosteroids to treat respiratory symptoms in former premature infants after controlling for medical conditions, socioeconomic status, and site of outpatient care.


METHODS
Using a population cohort of infants born at a gestational age < or = 34 weeks at 5 Northern California Kaiser Permanente hospitals between 1998 and 2001 (n = 1436), we constructed multivariable models to determine predictive factors for the receipt of respiratory medications during the first year after discharge.


RESULTS
After controlling for confounding factors, black infants were more likely to receive oral beta-agonists compared with white infants (OR 4.30, 95% CI 2.33-7.94), and Hispanic infants were less likely to receive inhaled beta-agonists (OR 0.62, 95% CI 0.39-0.99) or inhaled corticosteroids (OR 0.28, 95% CI 0.12-0.67). These findings were not explained by more outpatient visits for respiratory symptoms in black or Hispanic infants, because the observed racial differences persisted when children of similar respiratory symptoms were examined.


CONCLUSIONS
Even in a high-risk population of insured infants, substantial racial differences persist in the use of respiratory medications that could not be explained by differences in respiratory symptoms.
Department of Pediatrics, Division of Neonatology, University of Pennsylvania, Philadelphia, PA, USA. lorch@email.chop.edu
Scott A
SA
Lorch
Kelly C
KC
Wade
Susan
S
Bakewell-Sachs
Barbara
B
Medoff-Cooper
Gabriel J
GJ
Escobar
Jeffrey H
JH
Silber
D000280:Administration, Inhalation; D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D001997:Bronchopulmonary Dysplasia / Q000188:drug therapy / Q000208:ethnology; D002140:California; D017723:Drug Utilization Review; D005006:Ethnicity; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D008297:Male; D010351:Patient Discharge; D044469:Racial Groups; D012140:Respiratory Tract Diseases / Q000188:drug therapy* / Q000208:ethnology
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D000319:Adrenergic beta-Antagonists