ORIGINAL RESEARCH
Tahlia Hodes, MPH; Miguel Marino, PhD; Jennifer A Lucas, PhD; Andrew Bazemore, MD, MPH; Lars Peterson, MD, PhD; Michelle K. Trivedi, MD, MPH; Sophia Giebultowicz, MA; John Heintzman, MD, MPH
Corresponding Author: Tahlia Hodes, MPH; Department of Family Medicine, Oregon Health & Science University
Email: hodes@ohsu.edu
DOI: 10.3122/jabfm.2022.220379R1
Keywords: Asthma, Child, Health Equity, Latinx, Outcome Assessment, Primary Health Care
Dates: Submitted: 11-04-2022; Revised: 01-06-2023; Accepted: 01-17-2023
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BACKGROUND: Language concordance between Latinx patients and their clinicians has been shown to affect health outcomes. Additionally, there is evidence that consistent continuity of care (COC) can improve healthcare outcomes. The relationship between language concordance and COC and their association with health equity in chronic disease is less clear. Our aim was to study the moderating effect of clinician and patient language concordance on the association between COC and asthma care quality in Latinx children.
METHODS: We utilized an electronic health record dataset from a multistate network of community health centers to compare influenza vaccinations and inhaled steroid prescriptions, by ethnicity and language concordance groups overall and stratified by COC.
RESULTS: We analyzed electronic health records for children with asthma (n=38,442) age 3-17 years with >2 office visits between 2005-2017. Overall, 64% of children had low COC (defined as COC<0.5) while 21% had high COC (defined as >0.75). All Latinx children had higher rates and odds of receiving influenza vaccination compared to non-Hispanic White children. Additionally, Spanish-preferring Latinx children had higher rates and odds of being prescribed inhaled steroids while English-preferring Latinx children had lower odds (OR=0.85 95%CI=0.73,0.98) compared to non-Hispanic White children.
CONCLUSION: Overall Latinx children regardless of COC category or language concordance were more likely to receive the influenza vaccine. English-preferring Latinx children with persistent asthma received fewer inhaled steroid prescriptions compared to non-Hispanic White children. Panel chart review and seeing a practice partner might be one way to combat these inequities.