Poor asthma control more likely among publicly insured children, study finds
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Publicly insured children were more likely to have issues controlling their asthma than privately insured children, according to data presented at American Academy of Allergy, Asthma & Immunology Annual Meeting.
David Sanchez, MD, a fellow in the division of allergy and immunology at Mount Sinai Hospital in New York, presented results from a multi-institutional study.
According to Sanchez and colleagues, past studies on the same topic were limited by small sample sizes “and may not be reflective of the U.S. population.” Going into their study, which used a larger data set, the researchers hypothesized that children covered by public insurance would face higher odds of poor asthma control.
In a cross-sectional study using 2013 and 2018 data from the National Health Interview Survey that were representative of U.S. children with asthma and public insurance (n = 1,091,324) and private insurance (n = 1,230,098), they narrowed an original sample field of 21,129 children aged younger than 18 years to a final sample of 1,420 children who had self-reported a health care use related to an asthma diagnosis, while controlling for sex, age, race and ethnicity, parental education level, and preventive asthma medication use.
Sanchez and colleagues assessed three markers of poor asthma control: having a visit to the ER in the last year, being admitted into a hospital in the last year, and using more than three rescue inhalers in the past 3 months at the time of the survey.
Ultimately, the researchers found that children with public insurance experienced 47% increased odds (adjusted OR = 1.47; 95% CI, 1.01-2.15) of having an outcome of poor asthma control when compared with children with private insurance.
“This association is consistent across 2013 and 2018 and suggests disparities in pediatric asthma control by insurance persist,” they wrote.
Other studies have shown higher rates of neurodevelopmental disorder diagnoses, more issues with access to uninterrupted continuous glucose monitoring for people with diabetes, and lower overall survival rates for children with cancers, including soft tissue sarcoma, among publicly insured U.S. children.