DEMOGRAPHIC-PREDICTORS OF ASTHMA-TREATMENT SITE - OUTPATIENT, INPATIENT, OR EMERGENCY DEPARTMENT

Objective: To identify the demographic predictors of asthma treatment site: outpatient clinic, emergency department, or hospital. Methods: F rom the November 1993 to July 1995 claims data of the University of Co nnecticut Health Center, asthmatic patient sex, age, racial/ethnic gro up, address, and health insurance status were examined to identify pre dictors of treatment site. Patient addresses generated maps and census data. Results: 3288 visits were made by 1455 patients; 8%, 34%, and 5 8% came from poverty level, low, and higher income residential areas, respectively. Insurance type and then age were the most significant pr edictors of treatment site. Adults having commercial insurance or Medi care were most likely treated as outpatients, self-pay patients 5 time s more likely in the emergency department, and those receiving public assistance 2.4 times more likely in the hospital. Only 9% of Medicaid children and 22% with commercial insurance were evaluated as outpatien ts. Neither sex nor race/ethnicity was an important predictor of treat ment site. Conclusion: Although not population-based, this group of as thmatic patients represents a group diverse in socioeconomic status an d racial/ethnic background. Insurance category was the most influentia l factor predicting asthma treatment site, suggesting that economic st atus may be the most important determinant of higher morbidity. Childr en were treated predominantly in acute care settings.