title: Burden of COPD, asthma, and concomitant COPD and asthma among adults: racial disparities in a medicaid population.
abstract: BACKGROUND
  Asthma and COPD are characterized by substantial racial disparities in morbidity and mortality. We hypothesized that because African-American patients with these conditions experience greater mortality and morbidity than their white counterparts, they would use more health-care resources when no difference in health insurance exists.
  
  
  METHODS
  A retrospective, population-based cohort study was conducted using Maryland Medicaid Managed Care patient encounter data. We compared health services utilization and cost outcomes in both African-American and white patients with COPD, asthma, or coexisting COPD and asthma.
  
  
  RESULTS
  The study population consisted of 9,131 patients with COPD, asthma, or both conditions. Of the total population, 52% were African American (n = 4,723), and 44% were white (n = 4,021); all other races were combined into the "unknown race" category to account for the remaining 4% (n = 387). After controlling for age, gender, cohort allocation, and comorbidities, we found that African-American adults with COPD, asthma, or coexisting COPD and asthma actually used fewer medical services and accounted for lower medical costs than white adults.
  
  
  CONCLUSIONS
  Lower health services utilization and medical costs among African-American patients with COPD and asthma may provide a possible explanation for the racial disparities in outcomes of patients with these conditions.
authors.affiliation: Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD. Electronic address: fshaya@rx.umaryland.edu.
authors.forename: Fadia T
authors.initials: FT
authors.lastname: Shaya
authors.affiliation: Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Maneval
authors.affiliation: Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD.
authors.forename: Confidence M
authors.initials: CM
authors.lastname: Gbarayor
authors.affiliation: Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD.
authors.forename: Kyongsei
authors.initials: K
authors.lastname: Sohn
authors.affiliation: GlaxoSmithKline, Research Triangle Park, NC.
authors.forename: Anand A
authors.initials: AA
authors.lastname: Dalal
authors.affiliation: Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD.
authors.forename: Dongyi
authors.initials: D
authors.lastname: Du
authors.affiliation: Sleep Disorders Center, University of Maryland School of Medicine, Baltimore, MD.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Scharf