title: Medication use, emergency hospital care utilization, and quality-of-life outcome disparities by race/ethnicity among adults with asthma.
abstract: OBJECTIVE
  To examine the association of race/ethnicity with medication use, emergency hospital care (EHC) utilization, and quality-of-life outcomes in a population with persistent asthma and to determine if factors related to severity of illness, treatment characteristics, and demographic, socioeconomic, and smoking status explain differences in study outcomes.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  We examined survey and administrative data for 974 adults with persistent asthma enrolled in a group-model health maintenance organization. Patients with persistent asthma were identified in 1999 using Healthcare Effectiveness Data and Information Set inclusion criteria. In 2000, the same patients were surveyed regarding quality of life using the Mini Asthma Quality of Life Questionnaire. In 2001, the use of controller medications, the ratio of controller medications to rescue medications, and EHC utilization were identified by electronic medical record. Multiple logistic regression and linear regression analyses were used to evaluate the independent association of race/ethnicity with study outcomes after adjusting for severity of illness, treatment characteristics, and demographic, socioeconomic, and smoking status.
  
  
  RESULTS
  Compared with whites, African Americans (standardized β coefficient, -0.12) and Native Americans/Aleutians/Eskimos (standardized β coefficient, -0.14) had lower Mini Asthma Quality of Life Questionnaire scores (P <.05 for both). African Americans were significantly (P <.05) more likely to report EHC utilization (odds ratio, 5.2; 95% confidence interval, 2.6-10.3).
  
  
  CONCLUSIONS
  Disparities existed in 2 outcome measures, Mini Asthma Quality of Life Questionnaire scores and EHC utilization. A concerning finding is that African Americans were at least 5 times more likely to report higher EHC utilization, even after adjusting for factors such as income and education.
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, 3800 N Interstate Ave, Portland, OR 97227-1110, USA. david.m.mosen@kpchr.org
authors.forename: David M
authors.initials: DM
authors.lastname: Mosen
authors.forename: Michael
authors.initials: M
authors.lastname: Schatz
authors.forename: Rachel
authors.initials: R
authors.lastname: Gold
authors.forename: Richard A
authors.initials: RA
authors.lastname: Mularski
authors.forename: Winston F
authors.initials: WF
authors.lastname: Wong
authors.forename: Jim
authors.initials: J
authors.lastname: Bellows
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001249:Asthma / Q000188:drug therapy* / Q000208:ethnology / Q000523:psychology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D054624:Health Status Disparities; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D055553:Prescription Drugs; D011788:Quality of Life / Q000523:psychology*; D044469:Racial Groups / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D055553:Prescription Drugs