MedWire News: Having medical insurance and a medical provider is not enough to assure asthma control among school children, research shows.
"Our findings suggest that having access to medical care does not guarantee optimal care," said lead researcher Stanley Szefler, from National Jewish Health in Denver, Colorado, USA.
"Chronic diseases, such as asthma, require consistent, responsive management. It is up to patients and parents to recognize when their asthma management is not optimal, and to seek help to improve asthma management.”
Szefler and team studied the relationship between access to care and asthma control among 155 children with the respiratory condition from 19 elementary and middle schools in the Denver Public School system.
Although most (79%) qualified for free or reduced price lunches, indicating that they came from low-income families, 90% had medical insurance, of which 54% were public plans, and 92% had a physician caring for their asthma, the researchers note.
Analysis revealed that asthma control was similar, but overall poor, among students with and without medical insurance. For example, 30% of children with insurance had persistent daytime symptoms compared with 25% of those without insurance, and 57% of those with insurance had sought emergency care for their asthma compared with 63% of those who were uninsured.
There was no difference in asthma control between those who had private or public insurance, such as Medicaid.
The team also notes that just 30% of those with insurance used controller medications – the most effective method for managing asthma.
Having a medical provider also did not appear to improve asthma control. Indeed, children with doctors appeared to suffer more persistent daytime symptoms and were more likely to seek emergency care than those without doctors. Furthermore, only 25% of children with doctors were on regular controller therapy compared with 20% of those without a physician.
The authors suggest that the intermittent nature of pediatric asthma might be part of the problem, resulting in patients and their families not seeking regular asthma care.
“Patients need to realize that they can greatly reduce the symptoms of asthma and visits to the emergency room by properly and consistently managing their asthma," said Szefler. "If they have frequent shortness of breath or have had an emergency room visit, they need to ask their doctors how to better manage their disease. The vast majority of asthma patients should be able to live symptom-free and not have to limit their activities.”
Writing in the Journal of Allergy and Clinical Immunology, the team concludes that “children are in need of additional programs to identify, monitor, and educate those at high risk for asthma morbidity.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009
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