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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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