title: Increased healthcare resource utilization for acute respiratory illness among Latino infants.
abstract: OBJECTIVE
  To examine healthcare resource utilization for acute respiratory illness in Latino infants compared with other racial/ethnic groups.
  
  
  METHODS
  We studied 674 term-born, previously healthy infants brought in for an unscheduled healthcare visit for an acute respiratory illness. The predictor variable was infant race/ethnicity, and the primary outcome was healthcare resource utilization, adjusted for age and disease severity.
  
  
  RESULTS
  The cohort was 14% Latino, 52% white, 22% African American, and 12% other race/ethnicity. More than one-third (37%) of the mothers of Latino infants were Spanish-speaking. The bronchiolitis severity score was higher (indicating more severe disease) in white infants (median, 6.0; IQR, 3.0-9.0 on a scale of 0-12) compared with Latino (median, 3.0; IQR, 1.0-6.0) and African American (median, 3.5; IQR, 1.0-6.0) infants (P < .001 for the comparison of all groups). Disease severity was similar in Latino and African American infants (P = .96). Latino infants were the most likely to receive antibiotics (58%, compared with 47% of whites and 34% of African Americans; P = .005) and to have body fluid cultures drawn. Latino infants also were more likely than African American infants to undergo chest radiography and respiratory virus rapid antigen testing (P ≤ .01). Latino infants from Spanish-speaking families had a higher rate of respiratory syncytial virus testing compared with those from English-speaking families (76% vs 51%; P = .016).
  
  
  CONCLUSIONS
  Providers caring for Latino infants with acute respiratory illness ordered more antibiotics and diagnostic testing for this group, particularly compared with African Americans, even though the 2 groups had similar disease severity and socioeconomic disparities. Language barrier may be a possible explanation for these differences.
authors.affiliation: Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Valet
authors.forename: Tebeb
authors.initials: T
authors.lastname: Gebretsadik
authors.forename: Kecia N
authors.initials: KN
authors.lastname: Carroll
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Minton
authors.forename: Kimberly B
authors.initials: KB
authors.lastname: Woodward
authors.forename: Zhouwen
authors.initials: Z
authors.lastname: Liu
authors.forename: Rachel
authors.initials: R
authors.lastname: Hayes
authors.forename: Tina V
authors.initials: TV
authors.lastname: Hartert
mesh_terms: D000208:Acute Disease; D005006:Ethnicity; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007802:Language; D008297:Male; D018357:Respiratory Syncytial Virus Infections / Q000628:therapy*; D012141:Respiratory Tract Infections / Q000208:ethnology* / Q000628:therapy* / Q000821:virology; D012923:Social Class; D013714:Tennessee; D014481:United States
keywords: BSS; Bronchiolitis severity score; CSF; Cerebrospinal fluid; RSV; Respiratory syncytial virus