Abstract
Background
Foreign-born Latino children in the United States (US) have poor asthma outcomes,
but the role of routine care utilization in these outcomes is unclear. Our objective
was to compare select ambulatory care utilization measures for asthma between foreign-born
Latino, US-born Latino, and non-Hispanic white children.
Methods
Using a multistate network of clinics with a linked electronic health record, we compared
the International Classification of Disease (ICD)-coded asthma diagnosis among those
with respiratory symptoms, electronic health records documentation of diagnosis, prescriptions,
and influenza vaccination of foreign-born and US-born Latino children, and non-Hispanic
white children over a 10+ year study period. We also examined outcomes by country
of birth in children from Mexico, Cuba, and Guatemala.
Results
Among our study population (n = 155,902), 134,570 were non-Hispanic white, 19,143 were US-born Latino, and 2189
were foreign-born Latino. Among those with suspicious respiratory symptoms, there
was no difference between these groups in the predicted probability of an ICD-coded
asthma diagnosis. US-born Latino children with asthma were less likely to have asthma
documented on their problem list, more likely to have an albuterol prescription, and
less likely to have an inhaled steroid prescribed. All Latino children had higher
rates of influenza vaccination than non-Hispanic white children.
Conclusions
In a national network, there were few disparities between Latino (US- and foreign-born)
children and non-Hispanic white comparators in many common asthma care services, except
some measures in US-born Latino children. Providers should understand that their US-born
Latino children may be at elevated risk for not receiving adequate asthma care.
Keywords
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Article Info
Publication History
Published online: October 21, 2021
Accepted:
October 8,
2021
Received:
March 30,
2021
Footnotes
The authors have no conflicts of interest to disclose.
Identification
Copyright
© 2021 Published by Elsevier Inc. on behalf of Academic Pediatric Association
