-Asthma Prevalence Among Medicaid-Enrolled Children

Publication date: Available online 17 October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Anna Smith, Nicoleta Serban, Anne Fitzpatrick

Abstract

Background

Small-area asthma prevalence measures, which are crucial for targeting interventions, are currently sparsely available for children.

Objective

This study aims to provide measures of in-contact asthma prevalence for the 2012 Medicaid child population, to highlight areas in need of targeted asthma interventions.

Methods

Using the 2012 Medicaid Analytic eXtract (MAX) claims files, we develop two prevalence metrics differentiated by persistent or diagnosed asthma. We develop prevalence measures at the state, county, and census tract levels, with statistical inferences to highlight areas of high-prevalence where intervention should be focused. We compare the measures to asthma prevalence estimates derived from a sample of the child population who have self-reported whether they have been diagnosed with asthma regardless whether in-contact.

Results

1.98 million (8.1%) and 1.71 million (6.9%) Medicaid-enrolled children are identified with in-contact asthma diagnosis and persistent asthma, respectively. Among 40 states, 17 have lower prevalence estimates for the Medicaid-enrolled children than similar Centers for Disease Control and Prevention (CDC) child asthma self-reported prevalence estimates. High prevalence regions span primarily in the southern Midwest region, from Texas to West Virginia and Illinois to north Florida.

Conclusions

There are large variations in the differences between CDC self-reported estimates for the general population and the in-contact estimates for the Medicaid-enrolled children, highlighting potential asthma misdiagnosis in the Medicaid population in many states. Small area estimates point to areas of high prevalence, consistently throughout the south and southeast.