Predictors of asthma-related health care utilization and quality of life among inner-city patients with asthma

Juan P. Wisnivesky, Howard Leventhal, Ethan A. Halm

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background: Asthma morbidity and mortality are highest among minority inner-city populations. Objective: To identify factors associated with acute health care resource utilization and asthma-related quality of life among high-risk, minority patients with asthma. Methods: We interviewed a prospective cohort of 198 adults hospitalized for asthma in an inner city hospital over a period of 1 year. Detailed information about sociodemographics, asthma history, access to care, asthma medications, and self-reported allergy to aeroallergens was collected at baseline. Data on resource utilization (emergency department visits and hospital admissions for asthma) and asthma-related quality of life were obtained at 6 months after discharge. Multivariate analyses were used to identify predictors of resource utilization and quality of life. Results: The mean age of patients was 49.9 ± 17.4 years, 78% were women, and 97% were nonwhite. At 6 months, 49% of patients had an emergency department visit or hospitalization. In multivariate analysis, adjusting for age, sex, medication regimen, and asthma severity, patients with a physician in charge of their asthma care had lower odds of resource utilization (odds ratio, 0.4; P = .03). Conversely, a self-reported history of cockroach allergy was associated with greater utilization (odds ratio, 2.3; P = .05). Asthma-related quality of life was worse among patients who spoke mostly Spanish or who reported allergy to cockroaches (P < .004). Conclusion: Lack of an established asthma care provider, language barriers, and self-reported allergy to cockroaches are associated with higher resource utilization and worse quality of life among minority, inner-city patients with asthma. Interventions targeting these factors may lead to better outcomes among these patients.

Original languageEnglish (US)
Pages (from-to)636-642
Number of pages7
JournalJournal of Allergy and Clinical Immunology
Volume116
Issue number3
DOIs
StatePublished - Sep 2005

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Patient Acceptance of Health Care
Asthma
Quality of Life
Cockroaches
Hypersensitivity
Hospital Emergency Service
Multivariate Analysis
Odds Ratio
Communication Barriers
Health Resources
Urban Hospitals

Keywords

  • Allergic sensitization
  • Asthma
  • Hospitalization
  • Predictors
  • Quality of life

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Predictors of asthma-related health care utilization and quality of life among inner-city patients with asthma. / Wisnivesky, Juan P.; Leventhal, Howard; Halm, Ethan A.

In: Journal of Allergy and Clinical Immunology, Vol. 116, No. 3, 09.2005, p. 636-642.

Research output: Contribution to journalArticle

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AB - Background: Asthma morbidity and mortality are highest among minority inner-city populations. Objective: To identify factors associated with acute health care resource utilization and asthma-related quality of life among high-risk, minority patients with asthma. Methods: We interviewed a prospective cohort of 198 adults hospitalized for asthma in an inner city hospital over a period of 1 year. Detailed information about sociodemographics, asthma history, access to care, asthma medications, and self-reported allergy to aeroallergens was collected at baseline. Data on resource utilization (emergency department visits and hospital admissions for asthma) and asthma-related quality of life were obtained at 6 months after discharge. Multivariate analyses were used to identify predictors of resource utilization and quality of life. Results: The mean age of patients was 49.9 ± 17.4 years, 78% were women, and 97% were nonwhite. At 6 months, 49% of patients had an emergency department visit or hospitalization. In multivariate analysis, adjusting for age, sex, medication regimen, and asthma severity, patients with a physician in charge of their asthma care had lower odds of resource utilization (odds ratio, 0.4; P = .03). Conversely, a self-reported history of cockroach allergy was associated with greater utilization (odds ratio, 2.3; P = .05). Asthma-related quality of life was worse among patients who spoke mostly Spanish or who reported allergy to cockroaches (P < .004). Conclusion: Lack of an established asthma care provider, language barriers, and self-reported allergy to cockroaches are associated with higher resource utilization and worse quality of life among minority, inner-city patients with asthma. Interventions targeting these factors may lead to better outcomes among these patients.

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