Research Paper
Asthma and asthma-related health care utilization among people without disabilities and people with physical disabilities

Presentations: The results of this project were presented at the 2014 American Public Health Association Annual Meeting.
https://doi.org/10.1016/j.dhjo.2016.05.003Get rights and content

Abstract

Background

Previous research has shown that people with disabilities have higher rates of some chronic diseases and receive poorer disease-specific care than their counterparts without disabilities. Yet, little is known about the relationship between asthma and disability.

Objective

This study examines whether differences in the prevalence of asthma, asthma flare, and asthma-related measures of health care quality, utilization and cost exist among people with physical limitations (PL) and without any limitations.

Methods

Data from the 2004–2010 Medical Expenditure Panel Survey were pooled to compare outcomes for working-age adults (18–64) with PL to those with no limitations.

Results

People with PL had higher rates of asthma (13.8% vs. 5.9%, p < 0.001) and recent asthma flare (52.6% vs. 39.6%, p < 0.001) than people without limitations. There were no differences in health care quality, utilization or cost between people with PL and people without limitations in multivariate analyses.

Conclusions

Although there are no differences in asthma-related quality or utilization of health care, people with PL have poorer asthma control than people without limitations. Research is needed to determine what factors (e.g., focus on other acute ailments, perceptions that asthma control cannot improve) are related to this outcome. Future research must also examine differences in asthma severity, and its impact on asthma control and health care-related outcomes, among people with and without disabilities.

Section snippets

Methods

The Medical Expenditures Panel Survey (MEPS) collects health, disability, and health care utilization information on a nationally representative sample of the non-institutionalized civilian US population through a randomly selected subsample of the National Health Interview Survey.50 Data from the 2004–2010 Household Component, Self-Administered Questionnaire (SAQ), and medical conditions and events files were pooled to achieve a sample of sufficient size for examining small analytic groups.

Results

The sample of working-age adults and subsample of working-age adults with asthma represent approximately 175.7 million and 11.5 million people, respectively (Table 1). Approximately 11% of all working-age adults, and 23% of working-age adults with asthma, reported any PL. Both the sample and subsample are demographically diverse.

Nearly 7% of working-age adults self-reported asthma (Table 2). The prevalence of asthma is significantly higher among working-age adults with PL than adults with no

Discussion

In this study, we explored the prevalence of asthma and asthma flares as well as asthma-related health care quality, utilization, and expenditures among working-age adults with PL and without any limitations. Consistent with previous research using representative population-based samples,23, 26, 42 people with PL were found to have higher prevalence of asthma than people with no limitations. Working-age adults with PL were more likely to report an asthma flare in the past year but were,

Conclusion

Overall, working-age adults with PL were shown to have higher prevalence of asthma and recent asthma flares than do adults without limitations and to receive similar asthma-related health care quality and utilize similar amounts of asthma-related health care. Future research should examine the reasons why people with and without limitations are not meeting the NHLBI and HP 2020 recommendations for asthma-related care. The reasons, including asthma severity, comorbid conditions, tolerance for

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    Grant funding: The contents of this manuscript were developed by the Disability and Rehabilitation Research Project: Health and Healthcare Disparities among Individuals with Disabilities Project (Health Disparities Project), under a grant from the U.S. Department of Education, National Institute on Disability, Independent Living, and Rehabilitation Research (formerly the National Institute on Disability and Rehabilitation Research), grant #H133A100031. The contents do not necessarily represent the policy of the U.S. Department of Education and you should not assume endorsement by the Federal Government. NIDRR had no role in the study design, data collection or analysis, or in the interpretation of findings, and development of this manuscript. No other disclosures.

    Conflict of interest statement: The authors have no conflicts of interest to disclose.

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