Public insurance linked to longer perception of disease burden among children with asthma
The type of insurance coverage and intensity of asthma control influence the decline in children's perceived asthma burden over time, concludes a new study. Children with public insurance had an estimated slower drop in the perceived burden of asthma over time than children with other types of insurance. Children who received and enacted a high level of asthma control (medical visits and use of prescription medication) had a faster decline in perceived health burden and actual burden (sick days) than children who did not receive this level of asthma control. At the beginning of an observation period, a high level of asthma control was associated with a higher perceived health burden and mean number of disability days each month. By the end of the observation period, perceived health burden and disability days for children with high levels of asthma control had dropped below those for children with lower levels of asthma control.
The study highlights the importance of and benefits from high levels of asthma control, even for children who initially perceived a high health burden from the disease, conclude Gail Kieckhefer, Ph.D., P.N.P., of the University of Washington, and colleagues. They used data from the Agency for Healthcare Research and Quality (AHRQ) Medical Expenditure Panel Survey of representative U.S. households. The study used data on children with asthma from the 1996-1999 household panels, who were between 3 and 11 years of age at the first interview. The study followed patterns of change in two measures of health burden, perceived burden (on a five-point scale from "poor" to "excellent") and actual burden (in terms of total disability days per month). The study was funded in part by AHRQ (HS11301).
More details are in "Changes in the health burden of a national sample of children with asthma," by Nazli Baydar, Ph.D., Dr. Kieckhefer, Jutta M. Joesch, Ph.D., and others in the January 2010 Social Science & Medicine 70(2), pp. 321-328.
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