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Association of socioeconomic status with the use of chronic therapies and healthcare utilization in children with cystic fibrosis.
- Source :
-
The Journal of pediatrics [J Pediatr] 2009 Nov; Vol. 155 (5), pp. 634-9.e1-4. Date of Electronic Publication: 2009 Jul 16. - Publication Year :
- 2009
-
Abstract
- Objective: To determine whether previously reported socioeconomic status (SES)-related disparities in cystic fibrosis (CF) health outcomes vary by the indicator used (median household income by zip code [MIZ], maternal educational attainment [MEA], and state insurance coverage [MA]), and whether these disparities can be explained by differences in medical treatment.<br />Study Design: A cross-sectional analysis of data on patients age <18 years from the Epidemiologic Study of Cystic Fibrosis (ESCF).<br />Results: Disease severity showed a similar inverse correlation with all 3 SES measures. The number of stable clinic visits was unrelated to SES. Patients with MA had more sick outpatient visits and more courses of intravenous (IV) antibiotics for pulmonary exacerbations, and were more likely to be prescribed all chronic therapies. Low-MIZ patients had slightly fewer sick visits and more courses of IV antibiotics, and were more likely to receive oral nutrition supplements but less likely to receive macrolide prescriptions. Low-MEA patients were less likely to receive IV antibiotics at home, more likely to receive oral nutrition supplements, but less likely to receive macrolide prescriptions.<br />Conclusions: CF health outcomes are correlated with the SES spectrum, but these disparities are not explained by differential use of health services or prescription of chronic therapy. Future investigations should focus on the possible impact of environmental exposures and differences in disease self-management.
- Subjects :
- Adolescent
Age Factors
Child
Child, Preschool
Chronic Disease
Cross-Sectional Studies
Cystic Fibrosis diagnosis
Female
Health Knowledge, Attitudes, Practice
Health Services Accessibility economics
Humans
Infant
Infant, Newborn
Linear Models
Logistic Models
Long-Term Care economics
Male
Outcome Assessment, Health Care
Predictive Value of Tests
Probability
Risk Assessment
Severity of Illness Index
Sex Factors
Socioeconomic Factors
United States
Cost of Illness
Cystic Fibrosis economics
Cystic Fibrosis therapy
Health Services Accessibility statistics & numerical data
Healthcare Disparities statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6833
- Volume :
- 155
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The Journal of pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 19608199
- Full Text :
- https://doi.org/10.1016/j.jpeds.2009.04.059