TY - JOUR
T1 - Quality of Care for Latinx Children with Asthma
T2 - Associations with Language Concordance and Continuity of Care
AU - Hodes, Tahlia
AU - Marino, Miguel
AU - Lucas, Jennifer A.
AU - Bazemore, Andrew
AU - Peterson, Lars
AU - Trivedi, Michelle K.
AU - Giebultowicz, Sophia
AU - Heintzman, John
N1 - Publisher Copyright:
© 2023 American Board of Family Medicine. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Background: Language concordance between Latinx patients and their clinicians has been shown to affect health outcomes. In addition, there is evidence that consistent continuity of care (COC) can improve health care outcomes. The relationship between language concordance and COC and their association with health equity in chronic disease is less clear. Our aim was to study the moderating effect of clinician and patient language concordance on the association between COC and asthma care quality in Latinx children. Methods: We utilized an electronic health record dataset from a multistate network of community health centers to compare influenza vaccinations and inhaled steroid prescriptions, by ethnicity and language concordance groups overall and stratified by COC. Results: We analyzed electronic health records for children with asthma (n = 38,442) age 3 to 17 years with ≥2 office visits between 2005 to 2017. Overall, 64% of children had low COC (defined as COC<0.5) while 21% had high COC (defined as >0.75). All Latinx children had higher rates and odds of receiving influenza vaccination compared with non-Hispanic White children. In addition, Spanish-preferring Latinx children had higher rates and odds of being prescribed inhaled steroids while English-preferring Latinx children had lower odds (OR = 0.85 95%CI = 0.73,0.98) compared with non-Hispanic White children. Conclusion: Overall, Latinx children regardless of COC category or language concordance were more likely to receive the influenza vaccine. English-preferring Latinx children with persistent asthma received fewer inhaled steroid prescriptions compared with non-Hispanic White children. Panel chart review and seeing a practice partner might be one way to combat these inequities.
AB - Background: Language concordance between Latinx patients and their clinicians has been shown to affect health outcomes. In addition, there is evidence that consistent continuity of care (COC) can improve health care outcomes. The relationship between language concordance and COC and their association with health equity in chronic disease is less clear. Our aim was to study the moderating effect of clinician and patient language concordance on the association between COC and asthma care quality in Latinx children. Methods: We utilized an electronic health record dataset from a multistate network of community health centers to compare influenza vaccinations and inhaled steroid prescriptions, by ethnicity and language concordance groups overall and stratified by COC. Results: We analyzed electronic health records for children with asthma (n = 38,442) age 3 to 17 years with ≥2 office visits between 2005 to 2017. Overall, 64% of children had low COC (defined as COC<0.5) while 21% had high COC (defined as >0.75). All Latinx children had higher rates and odds of receiving influenza vaccination compared with non-Hispanic White children. In addition, Spanish-preferring Latinx children had higher rates and odds of being prescribed inhaled steroids while English-preferring Latinx children had lower odds (OR = 0.85 95%CI = 0.73,0.98) compared with non-Hispanic White children. Conclusion: Overall, Latinx children regardless of COC category or language concordance were more likely to receive the influenza vaccine. English-preferring Latinx children with persistent asthma received fewer inhaled steroid prescriptions compared with non-Hispanic White children. Panel chart review and seeing a practice partner might be one way to combat these inequities.
KW - Asthma
KW - Child
KW - Health Equity
KW - Language Concordance
KW - Latinx
KW - Outcome Assessment
KW - Primary Health Care
UR - http://www.scopus.com/inward/record.url?scp=85167842941&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85167842941&partnerID=8YFLogxK
U2 - 10.3122/jabfm.2022.220379R1
DO - 10.3122/jabfm.2022.220379R1
M3 - Article
C2 - 37321656
AN - SCOPUS:85167842941
SN - 1557-2625
VL - 36
SP - 1
EP - 10
JO - Journal of the American Board of Family Medicine
JF - Journal of the American Board of Family Medicine
IS - 4
ER -