The Pharmacy-Level Asthma Medication Ratio and Population Health

Beck, Andrew F.; Bradley, Courtney L.; Huang, Bin; Simmons, Jeffrey M.; Heaton, Pamela C.; Kahn, Robert S.

doi:10.1542/peds.2014-3796

Cited by 14 publications

(8 citation statements)

References 30 publications

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“…We expected that poverty would characterize a broad array of socioeconomic risk factors, whereas vehicle access would approximate one’s ability to access pharmacies (Greater Cincinnati’s public transportation system is limited). 20, 32 The poverty variable was defined as the percentage of individuals living at or below the federal poverty level. The vehicle access variable was defined as the percentage of households with no available vehicle.…”

Section: Methodsmentioning

confidence: 99%

Poverty, Transportation Access, and Medication Nonadherence

Hensley¹,

Heaton²,

Kahn³

et al. 2018

Pediatrics

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Section: Methodsmentioning

confidence: 99%

Poverty, Transportation Access, and Medication Nonadherence

Hensley¹,

Heaton²,

Kahn³

et al. 2018

Pediatrics

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“…Hospital-pharmacy partnerships could also be expanded to direct attention toward both high-risk populations and individual patients. 42 …”

Section: Evidence Supporting Place-based Assessmentsmentioning

confidence: 99%

Mapping Neighborhood Health Geomarkers To Clinical Care Decisions To Promote Equity In Child Health

et al. 2017

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Health disparities, which can be understood as disadvantages in health associated with one’s social, racial, economic, or physical environment, originate in childhood and persist across an individual’s life course. One’s neighborhood may drive or influence these disparities. Information on neighborhoods that can characterize their risks—what we call place-based risks—is rarely used in patient care. Community-level data, however, could inform and personalize interventions such as arranging for mold removal from the home of a person with asthma from the moment that person’s address is recorded at the site of care. Efficient risk identification could lead to the tailoring of recommendations and targeting of resources, to improve care experiences and clinical outcomes while reducing disparities and costs. In this article we highlight how data on place-based social determinants of health from national and local sources could be incorporated more directly into patient-centered care, adding precision to risk assessment and mitigation. We also discuss how this information could stimulate cross-sector interventions that promote health equity: the attainment of the highest level of health for neighborhoods, patient panels, and individuals. Finally, we draw attention to research questions that focus on the role of geographical place at the bedside.

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“…Our study demonstrated that increased neighborhood risks contribute to pediatric ED use and hospitalizations for asthma, confirming what has been documented in previous studies (8–16). Our results add to the growing body of evidence that diverse neighborhood factors (eg, crime rates [8], housing code violation density [9], pharmacy access [11], access to primary and specialty care [13], composites of variables specified by the US Census Bureau and the American Community Survey [10,12,14–16]) in various US cities, counties, and states affect pediatric outcomes such as ED visits and hospitalizations. Regardless of the components used to measure neighborhood risk or the level of geography, studies consistently show that children living in worse neighborhoods have higher risks of ED visits and hospitalizations.…”

Section: Discussionmentioning

confidence: 52%

Neighborhood Risk and Hospital Use for Pediatric Asthma, Rhode Island, 2005–2014

et al. 2019

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Introduction Studies consistently show that children living in poor neighborhoods have worse asthma outcomes. The objective of our study was to assess the association between negative neighborhood factors (ie, neighborhood risk) and pediatric asthma hospital use. Methods This retrospective study used data from children aged 2 to 17 years in a statewide (Rhode Island) hospital network administrative database linked to US Census Bureau data. We defined an asthma visit as an International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code of 493 in any diagnosis field. We used 8 highly correlated measures for each census-block group to construct an index of neighborhood risk. We used maps and linear regression to assess the association of neighborhood risk with average annual census-block–group rates of asthma emergency department visits and hospitalizations. We used multivariable analyses to identify child characteristics and neighborhood risk associated with an asthma revisit, accounting for the child’s sociodemographic information, season, and multiple measurements per child. Results From 2005 through 2014, we counted 359,195 visits for 146,889 children. Of these, 12,699 children (8.6%) had one or more asthma visits. Linear regression results showed 1.18 (95% confidence interval, 1.06–1.30) more average annual emergency departments visits per 100 children and 0.41 (95% confidence interval, 0.34–0.47) more average annual hospitalizations per 100 children in neighborhoods in the highest-risk index quintile than in neighborhoods in the lowest-risk index quintile. Conclusion Interventions to improve asthma outcomes among children should move beyond primary care or clinic settings and involve a careful evaluation of social context and environmental triggers.

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The Pharmacy-Level Asthma Medication Ratio and Population Health

Abstract: BACKGROUND AND OBJECTIVES: Community pharmacies may be positioned for an increased role in population health. We sought to develop a population-level measure of asthma medication fills and assess its relationship to asthma-related utilization.

Cited by 14 publications

References 30 publications

Poverty, Transportation Access, and Medication Nonadherence

Poverty, Transportation Access, and Medication Nonadherence

Mapping Neighborhood Health Geomarkers To Clinical Care Decisions To Promote Equity In Child Health

Neighborhood Risk and Hospital Use for Pediatric Asthma, Rhode Island, 2005–2014

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