Health Disparities in Pediatric Asthma: Comprehensive Tertiary Care Center Experience.
METHODS
Study conducted at Nemours /Alfred I. duPont Hospital for Children, Wilmington, DE 19803 BACKGROUND: Although the treatment and management of asthma hasimproved over time, incidence and prevalence among children continues to rise in the United States. Asthma prevalence, health services utilization, and mortality rate demonstrate remarkable disparities. The underlying causes of these disparities are not fully understood. We aimed to examine racial/ethnic variances in pediatric asthma prevalence/admission.


METHODS
We retrospectively reviewed data on 1070 patients and applied a cross-sectional design to assess asthma admission between 2010 and 2011. Information was available on race/ethnicity, sex, insurance status, severity of illness (SOI), and length of stay/hospitalization (LOS).Chi-square statistic was used for the association between race and other variables in an attempt to explain the racial/ethnic variance.


RESULTS
The proportionate morbidity of asthma was highest amongCaucasians (40.92%) and African Americans (40.54%), intermediate among others (16.57%), and lowest among Asian (0.56%), American Indian/Alaska Native (0.28%), and Hawaiian Native/Pacific Islander (0.28%). Overall there were disparities by sex, with more boys (61.80%) diagnosed with asthma than girls (38.20%), χ2(7)=20.1, p=0.005. Insurance status, and SOI varied by race/ethnicity, but not LOS. Caucasian children were more likely to have private insurance, while African Americans and Hispanics were more likely to have public insurance (p<0.005). Asthma was more severe among non-Hispanic children, χ2(14)=154.6, p<0.001. While the overall readmission proportion was 2.8%, readmission significantly varied by race/ethnicity.


CONCLUSIONS
Racial/ethnic disparities in asthma admission exist among children in the Delaware Valley. There were racial/ethnic disparities in insurance status, asthma severity, and sex differed by race/ethnicity, but not in length of hospitalization.
Health Equity & Inclusion Office, Nemours/AI DuPont Hospital for Children, Department of Biological Sciences, University of Delaware. Electronic address: holmes@medsci.udel.edu.
Laurens
L
Holmes
Health Equity & Inclusion Office, Nemours/AI DuPont Hospital for Children.
Fanta
F
Kalle
Health Equity & Inclusion Office, Nemours/AI DuPont Hospital for Children.
Laura
L
Grinstead
Health Equity & Inclusion Office, Nemours/AI DuPont Hospital for Children.
Maritza
M
Jimenez
Health Equity & Inclusion Office, Nemours/AI DuPont Hospital for Children.
Meghan
M
Murphy
Health Equity & Inclusion Office, Nemours/AI DuPont Hospital for Children.
Pat
P
Oceanic
Health Equity & Inclusion Office, Nemours/AI DuPont Hospital for Children.
Diane
D
Fitzgerald
Health Equity & Inclusion Office, Nemours/AI DuPont Hospital for Children.
Kirk
K
Dabney
Asthma admission; Delaware Valley; Health disparities; Pediatric asthma; Racial/Ethnic minorities