全民保险军人群中的儿童喘
Felicia Yeboah Denteh1,2, Wendy Vaughan1,2, Amanda Banaag1,2
1Center for Health Services Research, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
JAMA network open
|January 26, 2026
概括
儿童喘诊断和急诊诊断在黑人,西班牙裔和夏威夷原住民/太平洋岛民儿童中较高. 然而,喘治疗和吸入性皮质类固醇处方增加,这表明军事卫生系统人口的结果有所改善.
科学领域:
- 儿科肺病学 儿科肺病学
- 医疗服务研究 医疗服务研究
- 卫生公平性健康公平性
背景情况:
- 儿童喘患病率,治疗和结果因种族和族群而异,特别是在保险人群中.
- 了解这些差异对于有针对性的干预和改善儿童健康至关重要.
- 在多个层面上,社会经济因素影响了儿科喘风险.
研究的目的:
- 检查儿童喘诊断中的种族和种族差异.
- 调查与喘相关的医疗保健利用 (可能可以避免的住院,急诊室访问,专家访问) 和处方的差异.
- 通过使用TRICARE Prime数据,评估军事卫生系统 (MHS) 内的这些差异.
主要方法:
- 采用从MHS数据库获取的2023财年二级医疗保健和药房索赔数据进行横截面研究.
- 包括2至17岁的TRICARE Prime注册依赖者,至少有一次获得医疗服务.
- 种族和种族是主要变量,后勤回归分析了喘诊断,医疗保健利用和处方模式,控制了人口统计和医疗保健设置因素.
主要成果:
- 总共分析了950,896名儿童,其中3.3%被诊断患有喘. 在年长的儿童,男性和那些有1-2个兄弟姐妹的儿童中观察到更高的喘患病率.
- 黑人儿童患喘诊断的几率最高 (OR,1.85).
- 黑人 (OR,1.39),西班牙裔 (OR,1.36) 和夏威夷原住民/太平洋岛民 (OR,1.25) 的孩子有更高的喘相关的急诊室访问的几率. 可能可以避免的住院病例太少,无法进行有意义的分析. 喘治疗和吸入性皮质类固醇处方率在喘队列中增加.
结论:
- 尽管在喘诊断和急诊部使用方面观察到种族和种族差异,但MHS儿科患者在喘治疗和吸入皮质类固醇处方方面经历了改善.
- 这些发现表明,通过TRICARE提供的低成本或无成本医疗保健可能有助于更好的喘管理和结果.
- 进一步的研究是有必要的,以解决特定的差异,并优化喘护理在军事家庭内的多样化的儿科人口.
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