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Published on: August 7, 2017
Increased healthcare resource utilization for acute respiratory illness among Latino infants
Robert S Valet1, Tebeb Gebretsadik, Kecia N Carroll
1Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN.
Insights
Latino infants with acute respiratory illness received more antibiotics and diagnostic tests than other groups, despite similar disease severity. A language barrier may explain these disparities in healthcare resource utilization.
Area of Science:
- Pediatrics
- Health Services Research
- Health Disparities
Background:
- Acute respiratory illness is a common reason for healthcare visits in infants.
- Understanding racial/ethnic differences in healthcare resource utilization is crucial for addressing health disparities.
Purpose of the Study:
- To compare healthcare resource utilization for acute respiratory illness in Latino infants versus other racial/ethnic groups.
- To identify potential factors contributing to observed disparities in care.
Main Methods:
- A study of 674 previously healthy infants with acute respiratory illness.
- Infant race/ethnicity was the predictor variable; healthcare resource utilization was the primary outcome, adjusted for age and disease severity.
Main Results:
- Latino infants received more antibiotics (58%) and diagnostic tests (e.g., body fluid cultures, chest radiography, respiratory virus rapid antigen testing) compared to white and African American infants.
- Despite similar disease severity between Latino and African American infants, Latino infants were more likely to undergo certain tests and receive antibiotics.
- Latino infants from Spanish-speaking families had higher rates of respiratory syncytial virus testing.
Conclusions:
- Healthcare providers ordered more antibiotics and diagnostic tests for Latino infants with acute respiratory illness, particularly when compared to African American infants.
- Similar disease severity and socioeconomic factors between Latino and African American infants suggest other factors influence care patterns.
- A language barrier may be a contributing factor to the observed differences in healthcare resource utilization for Latino infants.
Objective:
To examine healthcare resource utilization for acute respiratory illness in Latino infants compared with other racial/ethnic groups.
Study Design:
We studied 674 term-born, previously healthy infants brought in for an unscheduled healthcare visit for an acute respiratory illness. The predictor variable was infant race/ethnicity, and the primary outcome was healthcare resource utilization, adjusted for age and disease severity.
Results:
The cohort was 14% Latino, 52% white, 22% African American, and 12% other race/ethnicity. More than one-third (37%) of the mothers of Latino infants were Spanish-speaking. The bronchiolitis severity score was higher (indicating more severe disease) in white infants (median, 6.0; IQR, 3.0-9.0 on a scale of 0-12) compared with Latino (median, 3.0; IQR, 1.0-6.0) and African American (median, 3.5; IQR, 1.0-6.0) infants (P < .001 for the comparison of all groups). Disease severity was similar in Latino and African American infants (P = .96). Latino infants were the most likely to receive antibiotics (58%, compared with 47% of whites and 34% of African Americans; P = .005) and to have body fluid cultures drawn. Latino infants also were more likely than African American infants to undergo chest radiography and respiratory virus rapid antigen testing (P ≤ .01). Latino infants from Spanish-speaking families had a higher rate of respiratory syncytial virus testing compared with those from English-speaking families (76% vs 51%; P = .016).
Conclusion:
Providers caring for Latino infants with acute respiratory illness ordered more antibiotics and diagnostic testing for this group, particularly compared with African Americans, even though the 2 groups had similar disease severity and socioeconomic disparities. Language barrier may be a possible explanation for these differences.
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