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The relationship of sex to asthma prevalence, health care utilization, and medications in a large managed care organization.
Ann Allergy Asthma Immunol. 2003 Dec; 91(6):553-8.AA

Abstract

BACKGROUND

Age-related sex differences in asthma hospitalizations and emergency department (ED) visits have been reported, but relationships of these differences to disease prevalence and outpatient management have not been defined.

OBJECTIVE

To define the relationships of sex to asthma-related health care utilization and medications, accounting for age-related differences in asthma prevalence.

METHODS

Computerized data from Southern California Kaiser-Permanente were used to identify asthmatic patients, aged 2 to 64 years, enrolled continuously during 1999 and 2000. Age-specific asthma prevalence in 1999 was calculated to identify ages of male or female predominance. Males and females were compared with regard to asthma-related health care utilization outcomes (outpatient clinic visits, ED visits, and hospitalizations) and medication use (beta-agonists, inhaled steroids, and oral steroids). Hospitalizations, ED visits, and oral steroid use were considered markers of disease severity.

RESULTS

Of the 60,694 subjects, the female-male prevalence ratio was approximately 35:65 at each age between 2 and 13 years, it was inverse (65:35) between the ages of 23 and 64 years, and prevalences were relatively similar at the ages of 14 to 22 years. In patients aged 2 to 13 years, most utilization and medication variables were significantly greater in males (P < .01). Females aged 14 to 22 years had more outpatient and ED visits and used more oral steroids than males. In patients aged 23 to 64 years, all utilization variables were significantly greater in females, except beta-agonist use and mean inhaled steroid dispensings.

CONCLUSIONS

Asthma utilization and severity appear greater in males aged 2 to 13 years, somewhat greater in females aged 14 to 22 years, and definitely greater in females aged 23 to 64 years. The mechanisms for these striking sex differences merit further investigation.

Authors+Show Affiliations

Department of Allergy, Kaiser-Permanente Medical Care Program, San Diego, California 92111, USA. michael.x.schatz@kp.orgNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

14700439

Citation

Schatz, Michael, and Carlos A. Camargo. "The Relationship of Sex to Asthma Prevalence, Health Care Utilization, and Medications in a Large Managed Care Organization." Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, vol. 91, no. 6, 2003, pp. 553-8.
Schatz M, Camargo CA. The relationship of sex to asthma prevalence, health care utilization, and medications in a large managed care organization. Ann Allergy Asthma Immunol. 2003;91(6):553-8.
Schatz, M., & Camargo, C. A. (2003). The relationship of sex to asthma prevalence, health care utilization, and medications in a large managed care organization. Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, 91(6), 553-8.
Schatz M, Camargo CA. The Relationship of Sex to Asthma Prevalence, Health Care Utilization, and Medications in a Large Managed Care Organization. Ann Allergy Asthma Immunol. 2003;91(6):553-8. PubMed PMID: 14700439.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The relationship of sex to asthma prevalence, health care utilization, and medications in a large managed care organization. AU - Schatz,Michael, AU - Camargo,Carlos A,Jr PY - 2004/1/1/pubmed PY - 2004/2/10/medline PY - 2004/1/1/entrez SP - 553 EP - 8 JF - Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology JO - Ann Allergy Asthma Immunol VL - 91 IS - 6 N2 - BACKGROUND: Age-related sex differences in asthma hospitalizations and emergency department (ED) visits have been reported, but relationships of these differences to disease prevalence and outpatient management have not been defined. OBJECTIVE: To define the relationships of sex to asthma-related health care utilization and medications, accounting for age-related differences in asthma prevalence. METHODS: Computerized data from Southern California Kaiser-Permanente were used to identify asthmatic patients, aged 2 to 64 years, enrolled continuously during 1999 and 2000. Age-specific asthma prevalence in 1999 was calculated to identify ages of male or female predominance. Males and females were compared with regard to asthma-related health care utilization outcomes (outpatient clinic visits, ED visits, and hospitalizations) and medication use (beta-agonists, inhaled steroids, and oral steroids). Hospitalizations, ED visits, and oral steroid use were considered markers of disease severity. RESULTS: Of the 60,694 subjects, the female-male prevalence ratio was approximately 35:65 at each age between 2 and 13 years, it was inverse (65:35) between the ages of 23 and 64 years, and prevalences were relatively similar at the ages of 14 to 22 years. In patients aged 2 to 13 years, most utilization and medication variables were significantly greater in males (P < .01). Females aged 14 to 22 years had more outpatient and ED visits and used more oral steroids than males. In patients aged 23 to 64 years, all utilization variables were significantly greater in females, except beta-agonist use and mean inhaled steroid dispensings. CONCLUSIONS: Asthma utilization and severity appear greater in males aged 2 to 13 years, somewhat greater in females aged 14 to 22 years, and definitely greater in females aged 23 to 64 years. The mechanisms for these striking sex differences merit further investigation. SN - 1081-1206 UR - https://www.unboundmedicine.com/medline/citation/14700439/The_relationship_of_sex_to_asthma_prevalence_health_care_utilization_and_medications_in_a_large_managed_care_organization_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1081-1206(10)61533-5 DB - PRIME DP - Unbound Medicine ER -