Chest
Original ResearchCOPDBurden of COPD, Asthma, and Concomitant COPD and Asthma Among Adults: Racial Disparities in a Medicaid Population
Section snippets
Design
This study used a retrospective patient encounters database, and the study period was 36 months, from January 1, 2001, to December 31, 2003. The study population was selected from the larger (> 400,000) pool of all Maryland Medicaid Managed Care beneficiaries. The race variable was drawn directly from encounter files in Medicaid data. African-American patients accounted for about half of the study population, with female beneficiaries constituting > 60%, and beneficiaries ≥ 17 years of age
Results
Table 1 shows the demographic characteristics of the three study cohorts. The total study population consisted of 9,131 patients with COPD, asthma, or both conditions. Of the total population, 52% were African American (n = 4,723), and 44% were white (n = 4,021); all other races were combined into an “unknown race” category to account for the remaining 4% of the population (n = 387).
The three cohorts were balanced with regard to the number of patients with a study condition, as follows: asthma,
Discussion
COPD and asthma present a number of medical, public health, and economic concerns for patients, physicians, and insurers as well as for the community, which often shares the impact of the disease. This study compared health services utilization and cost outcomes in Maryland Medicaid Managed Care adult beneficiaries with COPD, asthma, or coexisting COPD and asthma. We found significant differences by race in health services utilization. Contrary to our expectations across all three study
Acknowledgments
Author contributions: All authors participated in the study conception, design, analysis, interpretation of results, and revision of the manuscript, and approved the final version of the manuscript.
Financial/nonfinancial disclosures: The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Role of sponsors: The views expressed in this article are those of the authors and do
References (0)
Cited by (47)
National Trends and Disparities in Health Care Access and Coverage Among Adults With Asthma and COPD: 1997-2018
2021, ChestCitation Excerpt :Moreover, the literature on racial disparities in health care access among patients with COPD is relatively sparse.2,37 One study, confined to Maryland’s Medicaid managed care population, found that Black patients with asthma and COPD receive less health care than White patients.38 Another found that Black and Hispanic patients were less likely than non-Hispanic White patients to undergo pulmonary rehabilitation after a COPD hospitalization.39
Epidemiology of Chronic Obstructive Pulmonary Disease
2020, Clinics in Chest MedicineCitation Excerpt :In addition, African Americans report worse dyspnea and health-related quality of life than white people, after adjustment for lung function. One possible explanation may be their use of fewer respiratory medications, lower use of medical care, and poorer access to care.80,81 Another possible explanation is that African Americans are twice as likely than non-Hispanic white people to report a history of asthma.82
A Geographic Analysis of Racial Disparities in Use of Pulmonary Rehabilitation After Hospitalization for COPD Exacerbation
2020, ChestCitation Excerpt :Although in several HRRs, NHW Medicare beneficiaries are two to three times more likely to receive PR than the national average; regardless of where black beneficiaries live, their likelihood of receiving PR remains consistently below the national average and below NHW peers in the same HRR. Our findings add to research on the causes of health disparities in COPD and are consistent with prior studies that have found black patients with COPD use fewer health-care services than NHW patients.17,18 More research is needed to understand the forces driving the disparity in receipt of PR among black and NHW Medicare beneficiaries.
Prevalence and Medical Costs of Chronic Diseases Among Adult Medicaid Beneficiaries
2017, American Journal of Preventive MedicineCitation Excerpt :Of these, 29 original research articles12–40 met the selection criteria (Figure 1). Of these, 20 (69%) examined costs13,17,20–26,29–37,39,40 and 19 (66%) examined prevalence12–20,22,25,27–30,32,33,38,40; ten (34%) included both costs and prevalence.13,17,20,22,25,29,30,32,33,40 Among the 29 studies, 17 (59%) examined diabetes; 16 (55%), mental disorders; 15 (52%), respiratory illnesses; 15 (52%), heart disease and stroke; 12 (41%), hypertension; 11 (38%), other chronic conditions; ten (34%), cancer; seven (24%), multiple chronic conditions; and six (21%), dyslipidemia.
Effect of sequential treatment with TCM syndrome differentiation on acute exacerbation of chronic obstructive pulmonary disease and AECOPD risk window
2016, Complementary Therapies in Medicine
Funding/Support: This research was supported by National Heart, Lung, and Blood Institute Grant HL07441 (S.L.S.).
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).