M. Beth Benedict, DrPH, JD, Office of Research, Development, and Information, Centers for Medicare and Medicaid Services, 867 DeFranceaux Harbour, Riviera Beach, MD 21122, 410-786-7724, bbenedict@cms.hhs.gov

The purpose of this study was to develop national statistics on the race/ethnicity variations in the utilization of health care services and expenditures for asthma care, using the new Centers for Medicare and Medicaid Services (CMS) Medicaid Analytic eXtract (MAX)database that allows for nationally representative patterns and statistics. The database includes all fee-for-service and primary care case management claims, and the pre-paid managed care encounter claims to the extent they were reported to CMS in 1999, the first year that the 1996 federal requirement was implemented for this type of reporting. The study included the total population from all states and DC of enrolled children who had at least one claim for asthma-related care during 1999; and, was groupd by age-ranges in school (pre-schoolers, grade-schoolers, and high-schoolers). The findings showed similar variations in rates by race-ethnicity for use of inpatient and ambulatory care among the three age groups, and significantly higher rates of inpatient care among preschoolers and among minorities. Odds ratios and probabilities showed significantly higher likelihood of more severe asthma attacks among younger children, particularly among the minority groups. Across all race/ethnicity groups, patterns of asthma-related ambulatory care showed relatively high rates of access, however the rates were significantly different within the three school-age groups, and within each group the results were mixed for males and females. On average, the minority children hospitalized for asthma tended to account for more of the severe asthma attacks and usually had more comorbidities resulting in higher costs per stay, but often were discharged sooner than non-minorities. These variaitons in rates suggest that the minority children may be experiencing barriers to preventive and maintenance care aimed at reducing asthma attacks and their severity. However, the findings that these minority children who are discharged earlier also had higher repeat hospitalizations, raises important public health concerns about a need to minimize barriers to access, and to insure that all children in every community receive timely preventive and/or maintencance care according to the national guidelines.

Learning Objectives: At the conclusion of this session, the learner (participant) will be able to

• Discuss a new national profile of minority and non-minority Medicaid-covered children who received care for asthma during 1999 using data from all states and the District of Columbia.
• Explain the race/ethnicity national and regional variations in utilizatoin rates for inpatient and ambulatory asthma-related care for Medicaid-covered preschoolers, grade-schoolers, and high-schoolers.
• Discuss the statistics and ikelihood of severe asthma attacks among minority and non-minority Medicaid children.

Keywords: Asthma, Medicaid

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: The Center for Medicare and Medicaid Services (CMS) a federal Agency. No other entity.
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.