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Racial/ethnic disparities in the pharmacological management of pediatric asthma patients.

机译:小儿哮喘患者药理管理中的种族/种族差异。

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摘要

Pediatric patients have often received medications that are not effective in the management of their asthma. In 1991, in response to this situation, the National Heart, Lung, and Blood Institute (NHLBI) created the National Asthma Education and Prevention Program (NAEPP) composed of a panel of international experts who recommended a new treatment focus, which offered a treatment shift away from calming acute flare-ups to preventing serious attacks. It emphasized corticosteroid anti-inflammatory drugs as the foundation for the preventive treatment of asthma. The recommendations were published in the Expert Panel Report 2: Guidelines for the Diagnosis and Management of Asthma. This study analyzes data from the Medical Expenditure Panel Survey (MEPS). It uses a multinomial logit regression to predict the probability of a pediatric asthma patient receiving appropriate medications as outlined in the NAEPP Guidelines. Results show that African-American pediatric asthma patients are less likely to receive the medications the NAEPP Guidelines deem appropriate; they are more likely to receive either no medication or medications that do not control asthma symptoms effectively. Both African-Americans and Latinos are least likely to receive the recommended combination of medications---a beta 2-agonist and an inhaled corticosteroid. Whether or not a patient has either income or insurance had no effect on the results, therefore there is a factor external to the model, which is influencing the results. The catalyst for this difference may be the provider. He/she alone can bring about differences between racial groups. Through a clear understanding and through everyday practice of culturally competent medicine these differences in prescribing habits could be decreased. Therefore, there is an increased need for more emphasis on cultural competence by medical schools and policy makers.
机译:小儿患者经常接受对哮喘治疗无效的药物。 1991年,针对这种情况,美国国家心脏,肺和血液研究所(NHLBI)创建了国家哮喘教育和预防计划(NAEPP),该计划由一组国际专家组成,他们推荐了一个新的治疗重点,从而提供了一种治疗方法。从平息急性发作转变为防止严重发作。它强调皮质类固醇消炎药是预防哮喘的基础。这些建议已发表在专家小组报告2:哮喘诊断和管理指南中。这项研究分析了医疗支出小组调查(MEPS)的数据。它使用多项logit回归来预测NAEPP指南中概述的小儿哮喘患者接受适当药物的可能性。结果表明,非裔美国人的小儿哮喘患者不太可能接受NAEPP指南认为适当的药物;他们更有可能不接受任何药物或无法有效控制哮喘症状的药物。非洲裔美国人和拉丁美洲人都不太可能接受推荐的药物组合-β2激动剂和吸入性糖皮质激素。病人是否有收入或保险对结果没有影响,因此模型外部有一个因素会影响结果。造成这种差异的催化剂可能是提供者。他/她一个人就能带来种族群体之间的差异。通过清楚地了解和通过对具有文化能力的医学的日常实践,可以减少处方习惯方面的差异。因此,越来越需要医学院校和决策者更加重视文化能力。

著录项

  • 作者单位

    The University of Texas at Dallas.;

  • 授予单位 The University of Texas at Dallas.;
  • 学科 Health Sciences Public Health.; Health Sciences Pharmacology.; Sociology Ethnic and Racial Studies.
  • 学位 Ph.D.
  • 年度 2005
  • 页码 228 p.
  • 总页数 228
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 预防医学、卫生学;药理学;民族学;
  • 关键词

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