Investigators at University of Massachusetts Detail Findings in Asthma (Health Insurance Type and Outpatient Specialist Care Among Children With Asthma): Lung Diseases and Conditions – Asthma

2024 AUG 15 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- A new study on Lung Diseases and Conditions - Asthma is now available. According to news originating from Springfield, Massachusetts, by NewsRx correspondents, research stated, “Importance Although children with asthma are often successfully treated by primary care clinicians, outpatient specialist care is recommended for those with poorly controlled disease. Little is known about differences in specialist use for asthma among children with Medicaid vs private insurance.”

Financial supporters for this research include NIH National Heart Lung & Blood Institute (NHLBI), University of Massachusetts Center for Clinical and Translational Science-Biostatistics, Epidemiology & Research Design Component.

Our news journalists obtained a quote from the research from the University of Massachusetts, “To examine differences among children with asthma regarding receipt of asthma specialist care by insurance type. Setting, and Participants In this cross-sectional study using data from the Massachusetts All Payer Claims Database (APCD) between 2014 to 2020, children with asthma were identified and differences in receipt of outpatient specialist care by whether their insurance was public (Medicaid and the Children’s Health Insurance Program) or private were examined. Eligible participants included children with asthma in 2015 to 2020 aged 2 to 17 years. Data analysis was conducted from January 2023 to April 2024. Exposure Medicaid vs private insurance. Main Outcomes and Measures The primary outcome was receipt of specialist care (any outpatient visit with a pulmonology, allergy and immunology, or otolaryngology physician). Multivariable logistic regression models estimated differences in receipt of specialist care by insurance type accounting for child and area characteristics including demographics, health status, persistent asthma, calendar year, and zip code characteristics. Additional analyses examined if the associations of specialist care with insurance type varied by asthma persistence and severity, and whether associations varied over time. Among 198 101 unique children, there were 432 455 child-year observations (186 296 female [43.1%] and 246 159 male [56.9%]; 211 269 aged 5 to 11 years [48.9%]; 82 108 [19.0%] with persistent asthma) including 286 408 (66.2%) that were Medicaid insured and 146 047 (33.8%) that were privately insured. Although persistent asthma was more common among child-year observations with Medicaid vs private insurance (57 381 [20.0%] vs 24 727 [16.9%]), children with Medicaid were less likely to receive specialist care. Overall, 64 239 child-year observations (14.9%) received specialist care, with substantially lower rates for children with Medicaid vs private insurance (34 093 child-year observations [11.9%] vs 30 146 child-year observations [20.6%]). Regression-based estimates confirmed these disparities; children with Medicaid had 55% lower odds of receiving specialist care (adjusted odds ratio, 0.45; 95% CI, 0.43 to 0.47) and a regression-adjusted 9.7 percentage point (95% CI, -10.4 percentage points to -9.1 percentage points) lower rate of receipt of specialist care. Compared with children with private insurance, there was an additional 3.2 percentage point (95% CI, 2.0 percentage points to 4.4 percentage points) deficit for children with Medicaid with persistent asthma. Conclusions and Relevance In this cross-sectional study, children with Medicaid were less likely to receive specialist care, with the largest gaps among those with persistent asthma.”

According to the news editors, the research concluded: “These findings suggest that closing this care gap may be one approach to addressing ongoing disparities in asthma outcomes.”

For more information on this research see: Health Insurance Type and Outpatient Specialist Care Among Children With Asthma. JAMA Network Open, 2024;7(6). JAMA Network Open can be contacted at: Amer Medical Assoc, 330 N Wabash Ave, Ste 39300, Chicago, IL 60611-5885, USA.

The news correspondents report that additional information may be obtained from Kimberley H. Geissler, University of Massachusetts, Chan Med Sch Baystate, Dept Healthcare Delivery & Populat Sci, Springfield, MA, United States. Additional authors for this research include Meng-Shiou Shieh, Peter K. Lindenauer, Jerry A. Krishnan, Arlene S. Ash and Sarah L. Goff.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1001/jamanetworkopen.2024.17319. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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