CHILDREN with asthma enrolled in Arkansas Medicaid who received allergy specialist care had a 21% lower likelihood of experiencing asthma-related adverse events (AAEs) compared to those who did not.
Asthma is a common chronic condition in children, frequently requiring specialised care to manage symptoms and prevent exacerbations. Allergy specialists play a critical role in tailoring treatment plans, especially for children with persistent asthma or atopic conditions. Recent research aimed to evaluate whether children with asthma enrolled in the Arkansas Medicaid programme benefited from allergy specialist care in reducing AAEs, including emergency department visits and hospitalisations.
Using the Arkansas All-Payers Claims Database, researchers identified children enrolled in Medicaid who received allergy specialist care in 2018. These children were matched to peers who did not receive such care, using propensity score matching to account for differences such as asthma severity and vaccination status. The matched cohort included 2,964 children in each group, with 10.1% of participants experiencing an AAE in 2019. Logistic regression analysis revealed that children who visited an allergy specialist in 2018 had 21.0% lower odds of an AAE in 2019 compared to those without specialist care (adjusted odds ratio [aOR], 0.79; 95% confidence interval [CI], 0.63–0.98; P = 0.04). The marginal effect analysis showed a reduction in AAEs from 11.0% to 9.1%. Before matching, children who visited an allergy specialist were more likely to have persistent asthma, atopic conditions, and receive influenza vaccination, highlighting the role of targeted care in high-risk groups.
These findings underline the value of allergy specialist care in improving asthma outcomes for children enrolled in Medicaid. Incorporating guideline-based allergy specialist care into asthma management programmes could lead to significant reductions in emergency visits and hospitalisations. Developing quality metrics based on these recommendations could enhance patient outcomes and reduce healthcare utilisation. Future research should explore the long-term impact of allergy specialist care on asthma control and quality of life, while also assessing potential barriers to accessing this care within underserved populations.
Abigail Craig, EMJ
Reference
Boyd M et al. Association of Allergy Specialty Care and Asthma Outcomes for Medicaid-Enrolled Children. J Pediatr. 2024;277:114361.
