title: Factors associated with disparities in emergency department use among Latino children with asthma.
abstract: BACKGROUND
  Significant disparities in emergency department (ED) rates exist for Latinos; however, few studies have investigated the factors that may account for these disparities.
  
  
  OBJECTIVE
  To examine individual/family and health system factors among Latino and non-Latino white (NLW) children with asthma to explain disparities in ED rates.
  
  
  METHODS
  The study was carried out in Puerto Rico (PR) and Rhode Island (RI) with the same design: a cross-sectional, observational approach with repeated measurements of selected variables.
  
  
  RESULTS
  The sample was composed of 804 children ages 7 to 15 years, with 405 from PR and 399 from RI. Latino children from both sites had significantly higher rates of ED use as compared with NLWs from RI. Regression analyses showed site, asthma control, parental reported severity of asthma and public insurance to be significantly associated with ED use.
  
  
  CONCLUSIONS
  Latino ethnicity and public insurance were among the most important factors related to frequent ED use. Revisions of the policies driving public insurance to assure better access to specialists, preventive education, and evidence-based treatment are needed. The results also suggest the need for the development of interventions in the ED that are geared toward educating families on how best to use emergency services.
authors.affiliation: University of Puerto Rico, Medical Sciences Campus, Behavioral Sciences Research Institute, San Juan, Puerto Rico. glorisa.canino@upr.edu
authors.forename: Glorisa
authors.initials: G
authors.lastname: Canino
authors.forename: Aris
authors.initials: A
authors.lastname: Garro
authors.forename: Maria M
authors.initials: MM
authors.lastname: Alvarez
authors.forename: Angel
authors.initials: A
authors.lastname: Colón-Semidey
authors.forename: Cynthia
authors.initials: C
authors.lastname: Esteban
authors.forename: Gregory
authors.initials: G
authors.lastname: Fritz
authors.forename: Daphne
authors.initials: D
authors.lastname: Koinis-Mitchell
authors.forename: Sheryl J
authors.initials: SJ
authors.lastname: Kopel
authors.forename: Alexander N
authors.initials: AN
authors.lastname: Ortega
authors.forename: Ronald
authors.initials: R
authors.lastname: Seifer
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: McQuaid
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000453:epidemiology* / Q000503:physiopathology; D002648:Child; D003695:Delivery of Health Care; D018450:Disease Progression; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D005260:Female; D054625:Healthcare Disparities; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D011647:Puerto Rico / Q000208:ethnology; D012237:Rhode Island / Q000453:epidemiology