Racial Disparities in Medicaid Asthma Hospitalizations

Area of Science:

• Pediatric Asthma Care
• Health Disparities Research
• Healthcare Access and Equity

Background:

• Black children represent one-third of pediatric asthma patients covered by Medicaid.
• Increasing Medicaid coverage necessitates monitoring for racial disparities in hospital practices and patient outcomes.

Purpose of the Study:

• To investigate racial disparities in asthma-related hospital admission outcomes and practices between Black and white children enrolled in Medicaid.
• To compare key performance indicators such as revisit rates, readmission rates, length of stay, and intensive care unit (ICU) utilization.

Main Methods:

• A multivariate matched cohort design analyzed 11,079 matched pairs of Black and white children with asthma admitted to hospitals in 33 states.
• Data were sourced from Medicaid Analytic eXtract (MAX) claims between January 1, 2009, and November 30, 2010.
• Outcomes included 10-day and 30-day revisit/readmission rates, length of stay (LOS), and ICU use.

Main Results:

• No significant racial differences were found in 10-day revisit rates (3.8% vs. 4.2%) or 30-day revisit/readmission rates (10.5% vs. 10.8%).
• Length of stay was similar, with a median of 2.0 days for both groups, and a slightly lower percentage of Black patients exceeding their state's median LOS.
• Intensive care unit (ICU) use was significantly higher in Black patients (22.2%) compared to white patients (17.5%), with this disparity noted in 4 states after adjustment.

Conclusions:

• Racial disparities in asthma admission outcomes and hospital practices for closely matched Black and white Medicaid patients are generally small and not statistically significant.
• A notable exception is the higher utilization of intensive care units (ICU) among Black children with asthma compared to their white counterparts.