Document Detail


Racial differences in the use of respiratory medications in premature infants after discharge from the neonatal intensive care unit.
MedLine Citation:
PMID:  18035139     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the effect of race and ethnicity on the use of oral beta-agonists, inhaled beta-agonists, and inhaled corticosteroids to treat respiratory symptoms in former premature infants after controlling for medical conditions, socioeconomic status, and site of outpatient care. STUDY DESIGN: Using a population cohort of infants born at a gestational age < or = 34 weeks at 5 Northern California Kaiser Permanente hospitals between 1998 and 2001 (n = 1436), we constructed multivariable models to determine predictive factors for the receipt of respiratory medications during the first year after discharge. RESULTS: After controlling for confounding factors, black infants were more likely to receive oral beta-agonists compared with white infants (OR 4.30, 95% CI 2.33-7.94), and Hispanic infants were less likely to receive inhaled beta-agonists (OR 0.62, 95% CI 0.39-0.99) or inhaled corticosteroids (OR 0.28, 95% CI 0.12-0.67). These findings were not explained by more outpatient visits for respiratory symptoms in black or Hispanic infants, because the observed racial differences persisted when children of similar respiratory symptoms were examined. CONCLUSIONS: Even in a high-risk population of insured infants, substantial racial differences persist in the use of respiratory medications that could not be explained by differences in respiratory symptoms.
Authors:
Scott A Lorch; Kelly C Wade; Susan Bakewell-Sachs; Barbara Medoff-Cooper; Gabriel J Escobar; Jeffrey H Silber
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.     Date:  2007-08-24
Journal Detail:
Title:  The Journal of pediatrics     Volume:  151     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-23     Completed Date:  2007-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  604-10, 610.e1     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, Division of Neonatology, University of Pennsylvania, Philadelphia, PA, USA. lorch@email.chop.edu
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Administration, Oral
Adrenal Cortex Hormones / therapeutic use*
Adrenergic beta-Agonists / therapeutic use*
Adrenergic beta-Antagonists / therapeutic use*
Bronchopulmonary Dysplasia / drug therapy,  ethnology
California
Continental Population Groups*
Drug Utilization Review
Ethnic Groups*
Female
Healthcare Disparities*
Humans
Infant, Newborn
Infant, Premature
Intensive Care Units, Neonatal
Logistic Models
Male
Patient Discharge
Respiratory Tract Diseases / drug therapy*,  ethnology
Grant Support
ID/Acronym/Agency:
1 R40 MC05474-01-00//PHS HHS
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Adrenergic beta-Agonists; 0/Adrenergic beta-Antagonists

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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