A higher Asthma Medication Ratio (AMR) predicts a decrease in ED visits among African American and Hispanic children

Abstract

Introduction

Higher rates of ED visits and hospitalizations for asthma among African American and Hispanic children may indicate suboptimal management of asthma, leading to a greater financial burden of healthcare. It is not well known if an association of race/ethnicity with controller medication and hospital-based care utilization exists.

Objective

This study examines whether the Asthma Medication Ratio (AMR) predicts healthcare utilization for asthma by race/ethnicity.

Methods

4,584 Medi-Cal children (Ages 5–11) with persistent asthma in Los Angeles were identified and their AMRs (2018) were calculated based on the HEDIS criteria. Healthcare utilization data were used, including hospitalizations, ED visits, and pharmacy claims to examine whether a higher AMR predicts decreases in healthcare utilization by race/ethnicity in the subsequent 3,6, and 12 months (2019).

Results

The average AMR was lowest among African American children (0.401). In the subsequent 12 months, they were highest in ED visits (0.249) and hospitalizations (0.121), but lowest in outpatient visits (0.793). The results of logistic regression showed that a higher value of AMR (>0.5) contributed to decreases in ED visits in the subsequent 12 months only among African Americans (OR = 0.551, 95% CI 0.364–0.832) and Hispanics (OR = 0.613, 95% CI 0.489–0.770). No association between AMR and hospitalizations was found.

Conclusions

Our findings indicate that increased use of controller medication contributes to a decrease in ED visits among African American and Hispanic children with persistent asthma. Increased use of controller medications and caregiver’s efforts for medication adherence may contribute to a reduction in asthma disparities.

Keywords:

• pediatric asthma
• asthma disparities
• AMR
• controller medications
• Medicaid
• managed care

Declaration of interest

The authors report there are no competing interests to declare.

Funding

The authors received no financial support for the research.