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Medicaid School-aged Youth: Racial/Ethnic Variations in Ambulatory Service Rates and Expenditures for Asthma-related Care and Medication Prescription Fills in 2002

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

This comparative study developed a profile of >800,000 vulnerable, low-income Medicaid youth, using the 2002 CMS Medicaid Analytic eXtract (MAX) files in a national uniform format for multi-state analyses. Included were all fee-for-service, primary care case management claims, prescriptions filled, and encounter claims submitted to CMS. Youth who had at least one service for asthma were grouped by age: preschoolers, grade-schoolers, and adolescents Rates were computed by age, gender and race/ethnicity. Relative risks and odds ratios were constructed for services and prescriptions among Blacks and Whites, but not for other minorities because of insufficient numbers. Findings show high rates of asthma-care visits to providers especially among boys; but Black youth were only 10% as likely to have an ambulatory service as White youth. Rates adjusted for enrollment, race and gender found Hispanics have the highest rate of ambulatory care which included provider visits and asthma treatments. Rates varied when analyzing asthma-related prescription fill. The disparities in use of services have a mix of statistically and non-significant significant rates; however, clinically they are important. Findings demonstrate that in general, youth are receiving ambulatory care. School health services and the availability of nurses are essential for the delivery of timely needed asthma care, a continuing major public health policy concern. With local budget cuts in school systems, public health professionals must continue advocating for compliance with the NIH published National Asthma Education and Prevention Program clinical guidelines for care of youth with asthma in schools and in all settings.

Learning Objectives: Upon completion of this presentation, the learner will be able to

Keywords: School Health, Asthma

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None

Any relevant financial relationships? No

Dealing with Asthma in Schools

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA