Data Probe Association between Insurance Status and Asthma Severity and Care

An article published in the January, 2016, edition of the Western Journal of Emergency Medicine notes that “Previous studies have demonstrated an association of low socioeconomic status with frequent asthma exacerbations. However, there have been no recent multicenter efforts to examine the relationship of insurance status – a proxy for socioeconomic status – with asthma severity and management in adults.” The study investigated “chronic and acute asthma management disparities by insurance status among adults requiring emergency department (ED) treatment in the United States.”

Researchers conducted a chart review study “on ED patients, aged 18-54 years, with acute asthma between 2011 and 2012.” Patients were categorized “into three groups based on their primary health insurance: private, public, and no insurance. Outcome measures were chronic asthma severity (as measured by ≥2 ED visits in one-year period) and management prior to the index ED visit, acute asthma management in the ED, and prescription at ED discharge.”

Of the 1,928 ED patients studied, “33% had private insurance, 40% had public insurance, and 27% had no insurance. Compared to patients with private insurance, those with public insurance or no insurance were more likely to have ≥2 ED visits during the preceding year. Despite the higher chronic severity, those with no insurance were less likely to have guideline-recommended chronic asthma care – i.e., lower use of inhaled corticosteroids and asthma specialist care. By contrast, there were no significant differences in acute asthma management in the ED – e.g., use of systemic corticosteroids or initiation of ICS at ED discharge – by insurance status.”

The authors “found significant discrepancies in chronic asthma severity and management by insurance status. By contrast, there were no differences in acute asthma management among the insurance groups.”

For the full abstract and article, click here