Insurance and quality of care for children with acute asthma

Ambul Pediatr. 2001 Sep-Oct;1(5):267-74. doi: 10.1367/1539-4409(2001)001<0267:iaqocf>2.0.co;2.

Abstract

Background: Increasing attention has been paid to the role of insurance in determining quality and outcomes of care. Pressures to reduce health costs and to improve quality have prompted attempts by managed care organizations to decrease the use of the emergency department (ED) for acute asthma, but performance comparisons between insurance types remain rare.

Methods: We used prospective data from the Multicenter Airway Research Collaboration on 965 children with acute asthma presenting to 36 EDs. We compared measures of quality of pre-ED care, acute severity, and short-term outcomes (length of stay, percent relapse, and percent with ongoing symptoms) across 4 different insurance categories: managed care, indemnity, Medicaid, and uninsured. We used multivariate regression to control for differences in education, estimated income, race/ethnicity, and chronic asthma severity and acute asthma characteristics.

Results: Children with managed care and indemnity had similar demographic and asthma characteristics, but these children differed significantly from Medicaid and uninsured patients. Managed care and indemnity insured children had similar ratings on all 7 quality measures, with Medicaid and uninsured children ranking significantly lower on most measures, including (1) percent with primary care provider (PCP) (P <.001), (2) percent using ED as usual site of asthma care (P <.001), (3) percent using ED for prescriptions (P <.001), (4) percent with a ratio of >1 of ED visits to acute office visits within the past year (P =.003), and (5) percent visiting their PCP within the week prior to ED visit (P <.001). Children with managed care were more acutely ill than were indemnity, Medicaid, or uninsured children on presentation to the ED (pulmonary index of 4.6, 4.0, 4.2, and 3.9, respectively, P =.007). There were no significant differences in length of hospital stay, relapse, and ongoing exacerbation.

Conclusions: Our results indicate similar quality of care, greater severity of acute asthma, and no worse outcomes for children with managed care compared to children with indemnity insurance. We found uninsured children to have consistently poorer quality of care than insured patients.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Analysis of Variance
  • Asthma / classification
  • Asthma / diagnosis
  • Asthma / therapy*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Emergency Service, Hospital / economics*
  • Emergency Service, Hospital / standards*
  • Emergency Service, Hospital / statistics & numerical data
  • Emergency Treatment / economics
  • Emergency Treatment / standards
  • Female
  • Health Maintenance Organizations / economics*
  • Health Maintenance Organizations / standards
  • Health Maintenance Organizations / statistics & numerical data
  • Humans
  • Insurance Coverage
  • Male
  • Medicaid / economics*
  • Medicaid / standards
  • Medicaid / statistics & numerical data
  • Probability
  • Prognosis
  • Prospective Studies
  • Quality Assurance, Health Care / statistics & numerical data*
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Treatment Outcome
  • United States