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Home Research Research Library Role of social deprivation on asthma care quality among a cohort of children in US community health centres Role of social deprivation on asthma care quality among a cohort of children in US community health centres 2021 Author(s) Lucas, Jennifer A, Marino, Miguel, Fankhauser, Katie, Bazemore, Andrew W, Giebultowicz, Sophia, Cowburn, Stuart, Kaufmann, Jorge, Ezekiel-Herrera, David, and Heintzman, John D Topic(s) What Family Physicians Do Keyword(s) Children & Adolescents, and Population Health Volume BMJ Open Source BMJ Open Objective: Social deprivation is associated with worse asthma outcomes. The Social Deprivation Index is a composite measure of social determinants of health used to identify neighbourhood-level disadvantage in healthcare. Our objective was to determine if higher neighbourhood-level social deprivation is associated with documented asthma care quality measures among children treated at community health centres (CHCs). Methods (setting, participants, outcome measures) We used data from CHCs in 15 states in the Accelerating Data Value Across a National Community Health Center Network (ADVANCE). The sample included 34 266 children with asthma from 2008 to 2017, aged 3–17 living in neighbourhoods with differing levels of social deprivation measured using quartiles of the Social Deprivation Index score. We conducted logistic regression to examine the odds of problem list documentation of asthma and asthma severity, and negative binomial regression for rates of albuterol, inhaled steroid and oral steroid prescription adjusted for patient-level covariates. Results: Children from the most deprived neighbourhoods had increased rates of albuterol (rate ratio (RR)=1.22, 95% CI 1.13 to 1.32) compared with those in the least deprived neighbourhoods, while the point estimate for inhaled steroids was higher, but fell just short of significance at the alpha=0.05 level (RR=1.16, 95% CI 0.99 to 1.34). We did not observe community-level differences in problem list documentation of asthma or asthma severity. Conclusions: Higher neighbourhood-level social deprivation was associated with more albuterol and inhaled steroid prescriptions among children with asthma, while problem list documentation of asthma and asthma severity varied little across neighbourhoods with differing deprivation scores. While the homogeneity of the CHC safety net setting studied may mitigate variation in diagnosis and documentation of asthma, enhanced clinician awareness of differences in community risk could help target paediatric patients at risk of lower quality asthma care. ABFM Research Read all 2017 Preserving Primary Care Robustness Despite Increasing Health System Integration Go to Preserving Primary Care Robustness Despite Increasing Health System Integration 2019 Residency Program Characteristics and Individual Physician Practice Characteristics Associated With Family Physician Scope of Practice: Go to Residency Program Characteristics and Individual Physician Practice Characteristics Associated With Family Physician Scope of Practice: 2020 Practice Predictors of Buprenorphine Prescribing by Family Physicians Go to Practice Predictors of Buprenorphine Prescribing by Family Physicians 2016 US family physicians’ intrauterine and implantable contraception provision: results from a national survey Go to US family physicians’ intrauterine and implantable contraception provision: results from a national survey
Author(s) Lucas, Jennifer A, Marino, Miguel, Fankhauser, Katie, Bazemore, Andrew W, Giebultowicz, Sophia, Cowburn, Stuart, Kaufmann, Jorge, Ezekiel-Herrera, David, and Heintzman, John D Topic(s) What Family Physicians Do Keyword(s) Children & Adolescents, and Population Health Volume BMJ Open Source BMJ Open
ABFM Research Read all 2017 Preserving Primary Care Robustness Despite Increasing Health System Integration Go to Preserving Primary Care Robustness Despite Increasing Health System Integration 2019 Residency Program Characteristics and Individual Physician Practice Characteristics Associated With Family Physician Scope of Practice: Go to Residency Program Characteristics and Individual Physician Practice Characteristics Associated With Family Physician Scope of Practice: 2020 Practice Predictors of Buprenorphine Prescribing by Family Physicians Go to Practice Predictors of Buprenorphine Prescribing by Family Physicians 2016 US family physicians’ intrauterine and implantable contraception provision: results from a national survey Go to US family physicians’ intrauterine and implantable contraception provision: results from a national survey
2017 Preserving Primary Care Robustness Despite Increasing Health System Integration Go to Preserving Primary Care Robustness Despite Increasing Health System Integration
2019 Residency Program Characteristics and Individual Physician Practice Characteristics Associated With Family Physician Scope of Practice: Go to Residency Program Characteristics and Individual Physician Practice Characteristics Associated With Family Physician Scope of Practice:
2020 Practice Predictors of Buprenorphine Prescribing by Family Physicians Go to Practice Predictors of Buprenorphine Prescribing by Family Physicians
2016 US family physicians’ intrauterine and implantable contraception provision: results from a national survey Go to US family physicians’ intrauterine and implantable contraception provision: results from a national survey