Socioeconomic disparities in asthma health care utilization, exacerbations, and mortality: A systematic review and meta-analysis

Socioeconomic status is associated with healthcare seeking behaviour and disease burden in young adults with asthma – A nationwide cohort study

“… 11 We have previously demonstrated a strong association between higher SES and specialist referral for possible severe asthma patients, 9 which in the light of present findings suggest that secondary care attendance is less dependent on SES than the referral itself and that referrals of eligible patients indeed are lacking. 23 In contrast to previous studies demonstrating a neutral or slightly negative relationship between lower SES and primary care utilization, 6 , 11 the present cohort demonstrated a clear relationship between primary care utilization and lower SES, perhaps attributable to differences in registration and classification of asthma-related contacts in primary care between the studies.…”

“…Shifting healthcare seeking behaviours have previously been demonstrated in a recent systematic review, where lower SES was associated with increased unscheduled (ED visits and hospitalizations) secondary care utilization, in contrast to primary care. 6 In the present study, as well a recent Welsh study, no clear relationship between scheduled respiratory outpatient visits and SES was found. 11 We have previously demonstrated a strong association between higher SES and specialist referral for possible severe asthma patients, 9 which in the light of present findings suggest that secondary care attendance is less dependent on SES than the referral itself and that referrals of eligible patients indeed are lacking.…”

“… 11 Yet other factors seem important, as previous research has suggested that there exists a differential effect of SES on asthma outcomes depending on place of care, type of healthcare resource utilized, an effect seemingly independent of the larger organization of healthcare systems, such as insurance-based or universal access. 6 However, due to the common use of aggregate indexes for SES, little is known regarding what individual factors of SES are the main determinants of healthcare resource utilization (HRU) and, as much of the research on the topic is based on secondary care, the additional burden to primary care by asthma.…”

Benefits of specialist severe asthma management: demographic and geographic disparities

“…Crucially, only 12% of this study cohort were receiving biologic therapy as this analysis used data collected from patients registered during 2009 and 2010. Recent evidence from the UK and elsewhere has highlighted potential disparities in asthma morbidity based on patient's gender, ethnicity and socioeconomic status [15][16][17][18]. However, the moderating impact of demographic and geographic factors on outcomes among those treated in specialist asthma centres has yet to be assessed.…”

Understanding the highs and lows of socioeconomic status

“…In an article in this issue of the Journal of Allergy and Clinical Immunology, Redmond et al have performed a systematic review of the effect of SES on asthma outcomes internationally. 3 Studies were identified by including terms for asthma and terms related to SES (ie, income, poverty, education, employment status, and health care insurance coverage). After exclusions, Redmond et al 3 selected 61 studies (40 from the United States) that together included 1,145,704 patients and some measure of SES.…”