ICU use higher among black children with asthma

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Takeaway

  • Black children with asthma utilize the ICU more often than white children with asthma.
  • This utilization difference was greatest in Georgia, North Carolina, Tennessee, and Texas.

Why this matters

  • As the number of children in Medicaid increases, it is important to monitor potential racial disparities in hospitalization and outcomes.

Study design

  • Medicaid Analytic eXtract database.
  • 11,079 matched patient pairs hospitalized for asthma between January 2009 and November 2010.
  • 1 black patient and 1 white patient from the same state in each pair.
  • Funding: Agency for Healthcare Research and Quality and US National Science Foundation.

Key results

  • 23 deaths overall; 12 among black patients and 11 among white patients.
  • 10-d (P=.12) and 30-d (P=.58) revisit rate similar between groups.
  • Median length of stay (LOS) 2 d for both groups.
  • 22.2% of black patients used the ICU compared with 17.5% of white patients.
  • Difference between black and white patients was different across states for LOS (P=.002), ICU LOS (P<.001), and ICU use (P<.001), but not for 30-d revisit.
  • After adjusting for confounders, ICU use by black patients higher than white patients in Georgia, North Carolina, Tennessee, and Texas.

Limitations

  • Retrospective study.
  • Some states excluded.