Estimation of asthma incidence among low-income children in Texas: a novel approach using Medicaid claims data

Area of Science:

• Pediatric Epidemiology
• Public Health Surveillance
• Health Services Research

Background:

• Childhood asthma incidence data are scarce, hindering understanding of risk factors.
• Existing reports indicate disproportionate asthma burden among low-income children.
• Effective surveillance is crucial for public health interventions.

Purpose of the Study:

• To assess the utility of Medicaid claims data for estimating statewide childhood asthma incidence.
• To provide recent estimates of asthma incidence among Texas children.
• To identify demographic and geographic disparities in asthma incidence.

Main Methods:

• Utilized Texas Medicaid Analytic Extract (MAX) data for children aged 0-17 (2004-2007).
• Required a minimum 13-month continuous enrollment period to identify incident cases.
• Calculated age-adjusted asthma incidence rates overall and stratified by age, gender, race, and county.

Main Results:

• Age-adjusted asthma incidence was 4.26 per 100 person-years (2005-2007).
• Incidence decreased with age and was higher in males than females.
• Rates varied by race and were higher in rural compared to urban areas.

Conclusions:

• Medicaid claims data are a valuable resource for estimating childhood asthma incidence.
• Significant demographic and geographic variations in asthma incidence exist among Texas children.
• Methodology addresses challenges of unstable enrollment in Medicaid populations for accurate surveillance.