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Title of Journal: J GEN INTERN MED

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Abbravation: Journal of General Internal Medicine

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Springer-Verlag

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1525-1497

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Are Physician Estimates of Asthma Severity Less Ac

Authors: Sande O Okelo Albert W Wu Barry Merriman Jerry A Krishnan Gregory B Diette
Publish Date: 2007/04/24
Volume: 22, Issue: 7, Pages: 976-981
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Abstract

Racial differences in asthma care are not fully explained by socioeconomic status care access and insurance status Appropriate care requires accurate physician estimates of severity It is unknown if accuracy of physician estimates differs between black and white patients and how this relates to asthma care disparitiesWe conducted a crosssectional survey among adult patients with asthma cared for in 15 managed care organizations in the United States We collected physicians’ estimates of their patients’ asthma severity Physicians’ estimates of patients’ asthma as being less severe than patientreported symptoms were classified as underestimates of severityThree thousand four hundred and ninetyfour patients participated 13 were black Blacks were significantly more likely than white patients to have their asthma severity underestimated OR = 139 95 CI 108–179 Among black patients underestimation was associated with less use of daily inhaled corticosteroids 13 vs 20 p  05 less physician instruction on management of asthma flareups 33 vs 41 p  0001 and lower ratings of asthma care p = 01 and physician communication p = 04Dr Okelo was supported by grants from the National Institute of Environmental Health Science ES 09609 the Environmental Protection Agency R826724 and by the National Heart Lung and Blood Institute training grant HL07534 Dr Diette was supported by grants from the National Institutes of Health HL04266 and ES 09606 and the Environmental Protection Agency R826724 Dr Krishnan was supported by the Parker B Francis Foundation and the National Institutes of Health HL67850

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