title: The relationship between direct to consumer advertising (DTCA) and asthma-related emergency department use among Medicaid-enrolled children.
abstract: OBJECTIVE
  Asthma is a leading cause of emergency department (ED) visits. There has been much debate on the impact of direct to consumer advertising (DTCA) on healthcare. This study seeks to examine the association between DTCA expenditure and asthma-related ED use.
  
  
  METHODS
  In this study, we combined Medicaid administrative data and a national advertising data on asthma medications. The sample size consisted of 180,584 Medicaid-enrolled children between the ages of 5 and 18 years who had an asthma diagnosis. Twenty percent of the Medicaid-enrolled children in the sample had asthma-related ED visits.
  
  
  RESULTS
  We found that DTCA expenditure is associated with a decrease in asthma-related ED visits (OR = 0.75; CI: 0.64-0.89). However, at higher levels of DTCA expenditure, the likelihood of asthma-related ED visits increases (OR = 1.25; CI: 1.05-1.49), indicating a decreased relationship between DTCA and asthma-related ED visits.
  
  
  CONCLUSIONS
  Our findings suggest that DTCA may be associated with improved health outcomes for Medicaid-enrolled children with asthma.
authors.affiliation: Morehouse School of Medicine, National Center for Primary Care , Atlanta, GA , USA .
authors.forename: Luceta
authors.initials: L
authors.lastname: McRoy
authors.forename: Robert
authors.initials: R
authors.lastname: Weech-Maldonado
authors.forename: Meredith
authors.initials: M
authors.lastname: Kilgore
mesh_terms: D000367:Age Factors; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D004345:Drug Industry; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008389:Marketing of Health Services / Q000706:statistics & numerical data*; D008484:Medicaid / Q000706:statistics & numerical data*; D055553:Prescription Drugs / Q000008:administration & dosage / Q000627:therapeutic use*; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States
chemical_list: D055553:Prescription Drugs
keywords: Asthma; DTCA; Medicaid; disparities; pediatrics