Health outcomes in low-income children with current asthma in Canada.

Data collected from the Canadian National Longitudinal Survey of Children and Youth (NLSCY) in 1994/95 and 1996/97 were used to measure longitudinal health outcomes among children with asthma. Over 10 000 children aged 1 to 11 years with complete data on asthma status in both years were included. Outcomes included hospitalizations and health services use (HSU). Current asthma was defined as children diagnosed with asthma by a physician and who took prescribed inhalants regularly, had wheezing or an attack in the previous year, or had their activities limited by asthma. Children having asthma significantly increased their odds of hospitalization (OR = 2.52; 95% CI: 1.71, 3.70) and health services use (OR = 3.80; 95% CI: 2.69, 5.37). Low-income adequacy (LIA) in 1994/ 95 significantly predicts hospitalization and HSU in 1996/97 (OR = 2.68; 95% CI: 1.29, 5.59 and OR = 0.67; 95% CI: 0.45, 0.99, respectively). Our results confirmed that both having current asthma and living in low-income families had a significant impact on the health status of children in Canada. Programs seeking to decrease the economic burden of pediatric hospitalizations need to focus on asthma and low-income populations.

[1]  A. Kozyrskyj,et al.  Effect of cost-sharing on use of asthma medication in children. , 2008, Archives of pediatrics & adolescent medicine.

[2]  T. To,et al.  Persistence and remission in childhood asthma: a population-based asthma birth cohort study. , 2007, Archives of pediatrics & adolescent medicine.

[3]  N. Risch,et al.  Dissecting complex diseases in complex populations: asthma in latino americans. , 2007, Proceedings of the American Thoracic Society.

[4]  R. Glazier,et al.  Relationship between social inequalities and ambulatory care-sensitive hospitalizations persists for up to 9 years among children born in a major Canadian urban center. , 2007, Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association.

[5]  M. Beauchesne,et al.  Socioeconomic status and medication prescription patterns in pediatric asthma in Canada. , 2006, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[6]  H. Quan,et al.  Variation in health services utilization among ethnic populations , 2006, Canadian Medical Association Journal.

[7]  E. van Doorslaer,et al.  Inequalities in access to medical care by income in developed countries , 2006, Canadian Medical Association Journal.

[8]  G. Nocea,et al.  Asthma-related resource use and cost by GINA classification of severity in three European countries. , 2006, Respiratory medicine.

[9]  D. Wakefield,et al.  Risk factors for asthma and asthma severity in nonurban children in Connecticut. , 2005, Chest.

[10]  A. Sheikh,et al.  Ethnic variations in incidence of asthma episodes in England & Wales:national study of 502,482 patients in primary care , 2005, Respiratory research.

[11]  Glenn Flores,et al.  Keeping Children With Asthma Out of Hospitals: Parents' and Physicians' Perspectives on How Pediatric Asthma Hospitalizations Can Be Prevented , 2005, Pediatrics.

[12]  J. James Is Obesity Associated With Asthma in Young Children? , 2005, Pediatrics.

[13]  R. McConnell,et al.  Associations of place of birth with asthma and wheezing in Mexican American children. , 2005, The Journal of allergy and clinical immunology.

[14]  D. Gold,et al.  Immigration to the United States and acculturation as risk factors for asthma and allergy. , 2005, The Journal of allergy and clinical immunology.

[15]  W. Crown,et al.  Clinical and economic effects of suboptimally controlled asthma. , 2004, Managed care interface.

[16]  Glenn Flores,et al.  Keeping children out of hospitals: parents' and physicians' perspectives on how pediatric hospitalizations for ambulatory care-sensitive conditions can be avoided. , 2003, Pediatrics.

[17]  C. Mustard,et al.  Inhaled corticosteroids in childhood asthma: Income differences in use , 2003, Pediatric pulmonology.

[18]  P. Gibson,et al.  Migration to a western country increases asthma symptoms but not eosinophilic airway inflammation , 2003, Pediatric pulmonology.

[19]  D. Sin,et al.  Can universal access to health care eliminate health inequities between children of poor and nonpoor families?: A case study of childhood asthma in Alberta. , 2003, Chest.

[20]  B. Lindgren,et al.  Differences in health care utilisation and workdays lost between individuals with and without asthma. , 2003, Applied health economics and health policy.

[21]  A. Kalyoncu Symptoms of asthma, bronchial responsiveness and atopy in immigrants and emigrants in Europe , 2002, European Respiratory Journal.

[22]  F. Simons,et al.  Socioeconomic status, drug insurance benefits, and new prescriptions for inhaled corticosteroids in schoolchildren with asthma. , 2001, Archives of pediatrics & adolescent medicine.

[23]  H Kitzman,et al.  Medication use and health care contacts among symptomatic children with asthma. , 2001, Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association.

[24]  Ross Upshur,et al.  A population based time series analysis of asthma hospitalisations in Ontario, Canada: 1988 to 2000 , 2001, BMC health services research.

[25]  P. Coyte,et al.  Prospective study of the patient‐level cost of asthma care in children * , 2001, Pediatric pulmonology.

[26]  T. To,et al.  Biological, social, and environmental correlates of preschool development. , 2001, Child: care, health and development.

[27]  D Krewski,et al.  Asthma and the risk of hospitalization in Canada : the role of socioeconomic and demographic factors. , 2001, Chest.

[28]  A. Hjern,et al.  Social adversity, migration and hospital admissions for childhood asthma in Sweden , 1999, Acta paediatrica.

[29]  Anne Gadomski,et al.  Impact of a Medicaid Primary Care Provider and Preventive Care on Pediatric Hospitalization , 1998, Pediatrics.

[30]  B. Starfield,et al.  Hospitalizations of Children and Access to Primary Care: A Cross-National Comparison , 1995, International journal of health services : planning, administration, evaluation.

[31]  P. Diggle Analysis of Longitudinal Data , 1995 .

[32]  S. Lipsitz,et al.  Performance of generalized estimating equations in practical situations. , 1994, Biometrics.

[33]  P. Diggle,et al.  Modelling multivariate binary data with alternating logistic regressions , 1993 .

[34]  P. Newacheck,et al.  Childhood asthma and poverty: differential impacts and utilization of health services. , 1993, Pediatrics.

[35]  D. Hosmer,et al.  Applied Logistic Regression , 1991 .