Asthma
Sufferers on Medicaid Face Unique Barriers to Care
Families
insured by Medicaid face unique barriers to asthma management, including
income level and insurance limitations, according to a study that
appears in the March issue of CHEST, the peer-reviewed journal of
the American College of Chest Physicians.
Researchers
from the University of Michigan, Ann Arbor, MI, and the University
of Utah, Salt Lake City, UT, evaluated focus group responses from
36 primary caregivers of children with asthma who were currently
using or previously used Medicaid insurance. Of the participants,
23 (64 percent) were African-American, 32 (89 percent) were the
biological mother, and 25 (69 percent) reported an annual income
of less than $20,000.
Overall, caregivers
demonstrated a high level of asthma knowledge but also identified
unique obstacles that prevented the effectiveness of asthma management.
These barriers included difficulty maintaining continuity of care
due to physician participation in Medicaid programs; concerns about
possible differences in asthma care from health-care providers due
to their Medicaid insurance status; and the inability to afford
asthma supplies. A specific gap also was seen in the caregiver's
level of self-efficacy to control exposure to asthma triggers, monitor
the child's symptoms, and modify medications based on asthma symptoms.
To overcome
some or all of these barriers, researchers suggest that physicians
employ strategies that demonstrate to patients and caregivers that
decisions for care are not based on the type of patient insurance.
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