Document Detail

Trends in private insurance, Medicaid/State Children's Health Insurance Program, and the health-care safety net: implications for asthma disparities.
MedLine Citation:
PMID:  17998346     Owner:  NLM     Status:  MEDLINE    
Disparities in asthma prevalence, severity, quality of care, and outcomes have been widely documented across racial/ethnic communities, among privately insured vs publicly insured patients, and according to patients' socioeconomic status, among other patient characteristics. In order to effectively address asthma disparities, changes will need to be made across all systems of care in which these subpopulations receive health-care services. The majority of current trends in private insurance, Medicaid/State Children's Health Insurance Program, and the safety net are likely to further exacerbate asthma disparities rather than help to reduce these disparities. Asthma cannot be effectively managed unless individuals have affordable access to a full range of services and receive coordinated, quality health care. Multiple policy levers will need to be simultaneously employed to ensure access to the full range of services needed for effective asthma management, especially among low-income and minority persons with asthma in order to reduce the gap in disparities. The needs of these patients must be thoughtfully addressed and strategically advocated for within all systems of care in which these subpopulations receive health services. This overall strategy must necessarily include consideration of the capacity of safety-net providers to meet the needs of uninsured and underinsured persons with asthma. This article reviews trends in health-care financing, in clinical management, and the health-care safety net, and assesses their likely impact on asthma disparities. It concludes with a discussion of key policy arenas that will have significant influence on the eventual success of efforts to reduce asthma disparities.
Alexandra E Shields
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Chest     Volume:  132     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-11-13     Completed Date:  2008-01-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  818S-830S     Citation Subset:  AIM; IM    
Massachusetts General Hospital/Partners HealthCare, Institute for Health Policy, 50 Staniford St, 9th Floor, Suite 901, Boston, MA 02114, USA.
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MeSH Terms
Aid to Families with Dependent Children*
Asthma / economics*,  epidemiology,  ethnology
Child Health Services / economics*
Cost Control
Disease Management
Health Policy
Health Services Accessibility*
Health Status Disparities
Healthcare Disparities
Insurance, Health / economics,  trends*
Medical Records Systems, Computerized
Medically Uninsured / statistics & numerical data
United States / epidemiology

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

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