Latino-white disparities in ICD-coded asthma diagnosis among US children

Abstract

Introduction

It is uncertain if disparities in asthma diagnosis between Latino and non-Hispanic white children stem from differences in diagnosis over time among children presenting with similar clinical scenarios suggestive of asthma.

Methods

We evaluated the odds of International Classification of Disease (ICD)-coded asthma diagnosis in Latino (English and Spanish preferring) and non-Hispanic white children, overall (N = 524,456) and among those presenting with possible asthma indicators (N = 85,516) over a 13-year period, using electronic health record data from a multi-state network of community health centers.

Results

Among those with possible asthma indicators, Spanish-preferring Latinos had lower adjusted odds of ICD-coded asthma diagnosis compared to non-Hispanic whites (OR = 0.87, 95%CI = 0.77-0.99); English-preferring Latinos did not differ from non-Hispanic whites. Differences in ICD-coded diagnosis between ethnicity/language groups varied by presenting symptom.

Conclusions

Spanish-preferring Latino children may be less-likely to have ICD-coded asthma documented in the EHR when presenting with certain clinical indicators suggestive of asthma. Clinicians should be cognizant of the need for the follow-up of these indicators in Spanish-preferring Latino children.

Keywords:

• Health inequity
• primary care
• electronic health records

Acknowledgements

This research was conducted with Accelerating Data Value Across a National Community Health Center Network (ADVANCE) Clinical Research Network (CRN), a member of PCORnet, an initiative originally funded by the Patient Centered Outcomes Research Institute (PCORI) and now funded by the People-Centered Research Foundation (PCRF). The ADVANCE network is led by OCHIN in partnership with Health Choice Network, Fenway Health, Oregon Health and Science University, and the Robert Graham Center/HealthLandscape. ADVANCE is funded through PCRF contract number 1237.

Declaration of interest

The authors listed above have no conflicts of interest, real or perceived.

Additional information

Funding

This work was supported by the National Institute on Minority Health and Health Disparities under grant number R01MD011404.