0
Abstract: Poster Presentations |

BURDEN OF CONCOMITANT CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ASTHMA AMONG ADULTS: RACIAL DISPARITIES EXISTENT IN A MEDICAID POPULATION FREE TO VIEW

Fadia T. Shaya, PhD; Anand A. Dalal, PhD*; Dongyi Du, MSc
Author and Funding Information

GlaxoSmithKline, Research Triangle Park, NC


Chest


Chest. 2008;134(4_MeetingAbstracts):p21002. doi:10.1378/chest.134.4_MeetingAbstracts.p21002
Text Size: A A A
Published online

Abstract

PURPOSE: To examine and explain racial disparities, in comorbid asthma/COPD subjects (defined based on co-occurring diagnoses codes) and compare with patients with asthma alone or COPD alone in a Medicaid population.

METHODS: A retrospective population-based cohort study was conducted using Maryland Medicaid Managed Care patient encounter data (study period 1/1/2001 to 12/31/2003). Patients enrolled were adults aged 40–64 years as of 1/1/2001 with at least 360 days of follow-up from first medical claim (dual eligible excluded). COPD patients were identified based on claims with ICD-9 codes 491.xx, 492.xx, 496.xx, and asthma patients on the basis of ICD-9 code 493.xx in the primary, secondary or tertiary diagnosis field. Charlson Comorbidity Index (CCI) was used to adjust for the severity of comorbidities. We compared healthcare resource utilization and cost-outcomes in African American patients with other patients with COPD, asthma or co-occurring COPD and asthma. Multivariate analyses were conducted using logistic regression models, to predict utilization patterns and costs.

RESULTS: The analysis included 3,072 asthma patients, 3,455 COPD patients, and 2,604 asthma/COPD patients. After controlling for age, gender, cohort allocation, and comorbid conditions, the study found significant differences of healthcare resource utilization by race. African American (AA) patients used 17% fewer medical services, including physician visits, hospitalizations and emergency room visits, than Caucasian patients (OR=0.83, 95% CI: 0.75–0.93). AA patients showed 18% less utilization of outpatient services (OR=0.82, 95% CI: 0.74–0.91) and 15% less utilization of inpatient services than Caucasians (OR=0.85, 95% CI: 0.76–0.94). Overall, Asthma/COPD comorbid group also was more than 5 times likely to have a hospitalization (OR=5.21, CI 4.55–5.97) and to be in the higher 75th percentile costs compared to those in asthma group (OR=5.25, CI 4.59–6.02).

CONCLUSION: The study concludes show that AA adults, in COPD, asthma or comorbid asthma/COPD groups, use fewer medical services and account for lower medical costs than Caucasians.

CLINICAL IMPLICATIONS: Care is needed to address disparities due to race in certain populations as far as COPD is concerned.

DISCLOSURE: Anand Dalal, Employee Anand Dalal is currently employed by GlaxoSmithKline (GSK); Consultant fee, speaker bureau, advisory committee, etc. Fadia Shaya was a consultant at University of MD who received funding from GSK to complete this analysis. Other authors were also funded by GSK.; No Product/Research Disclosure Information

Tuesday, October 28, 2008

1:00 PM - 2:15 PM


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543