RT Journal Article
SR Electronic
T1 Mobility and social deprivation on primary care utilisation among paediatric patients with asthma
JF Family Medicine and Community Health
JO Fam Med Com Health
FD BMJ Publishing Group Ltd
SP e001085
DO 10.1136/fmch-2021-001085
VO 9
IS 3
A1 Jennifer A Lucas
A1 Miguel Marino
A1 Sophia Giebultowicz
A1 Katie Fankhauser
A1 Shakira F Suglia
A1 Steffani R Bailey
A1 Andrew Bazemore
A1 John Heintzman
YR 2021
UL http://fmch.bmj.com/content/9/3/e001085.abstract
AB Objective Asthma care is negatively impacted by neighbourhood social and environmental factors, and moving is associated with undesirable asthma outcomes. However, little is known about how movement into and living in areas of high deprivation relate to primary care use. We examined associations between neighbourhood characteristics, mobility and primary care utilisation of children with asthma to explore the relevance of these social factors in a primary care setting.Design In this cohort study, we conducted negative binomial regression to examine the rates of primary care visits and annual influenza vaccination and logistic regression to study receipt of pneumococcal vaccination. All models were adjusted for patient-level covariates.Setting We used data from community health centres in 15 OCHIN states.Participants The sample included 23 773 children with asthma aged 3–17 across neighbourhoods with different levels of social deprivation from 2012 to 2017. We conducted negative binomial regression to examine the rates of primary care visits and annual influenza vaccination and logistic regression to study receipt of pneumococcal vaccination. All models were adjusted for patient-level covariates.Results Clinic visit rates were higher among children living in or moving to areas with higher deprivation than those living in areas with low deprivation (rate ratio (RR) 1.09, 95% CI 1.02 to 1.17; RR 1.05, 95% CI 1.00 to 1.11). Children moving across neighbourhoods with similarly high levels of deprivation had increased RRs of influenza vaccination (RR 1.13, 95% CI 1.03 to 1.23) than those who moved but stayed in neighbourhoods of low deprivation.Conclusions Movement into and living within areas of high deprivation is associated with more primary care use, and presumably greater opportunity to reduce undesirable asthma outcomes. These results highlight the need to attend to patient movement in primary care visits, and increase neighbourhood-targeted population management to improve equity and care for children with asthma.Data may be obtained from a third party and are not publicly available. Data are a limited (partially deidentified) dataset from electronic health records. Data are available to investigators for a fee for those who are willing and able to partner with OCHIN on their analysis.