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Does your child have asthma? Parent reports and medication use for pediatric asthma
1Department of Pediatrics and Institute for Health Policy Studies, University of California, San Francisco 94143-0503, USA. erobert@itsa.ucsf.edu
Objective:
To assess parental reporting of diagnosis used in surveys as an indicator of pediatric asthma prevalence.
Methods:
Analysis of the Medical Expenditure Panel Survey, 1996 and 1997 (10 404 children aged from 0 to 17 years). All values are expressed as mean (SE).
Results:
Asthma medications were purchased for 2.5% (0.2%) of children. Parents of 45.4% (4.0%) of these children failed to report asthma, including 41.3 (10.5%) of those for whom maintenance medications were purchased. These findings remained unchanged when very young children were excluded from the sample. Controlling for insurance coverage, no racial, ethnic, or socioeconomic disparities in reported asthma were found; however, poor children were more likely to have maintenance medications purchased (odds ratio, 4.9; 95% confidence interval, 2.3-10.4).
Conclusions:
Surveys of parental reports of asthma overlook many children with active disease. Dependence on parental reports may underestimate the prevalence of serious asthma among poor children. The parents in this study who fail to report asthma may represent a group that perceives their children's disease as less serious a problem despite active purchasing of medications.