ABSTRACT. Objective. To investigate racial/ethnic differences in acute asthma among children who present to the emergency department (ED).Method. We analyzed data from 2 prospective cohort studies performed during 1997-1998 as part of the Multicenter Airway Research Collaboration. Using a standardized protocol, researchers at 40 EDs in 18 US states provided 24-hour-per-day coverage for a median of 2 weeks per year. Children with acute asthma were interviewed in the ED and by telephone 2 weeks after discharge.Results. Among 1095 patients, 679 (62%) were black, 256 (23%) were Hispanic, and 160 (15%) were white. Black and Hispanic children had greater histories of lifetime (63%, 64%, 46%) and past-year (34%, 31%, 14%) hospitalization and more ED visits in the past year (medians: 2, 3, 1). Asthma severity at ED presentation, ED management and course, hospitalization during the index visit, discharge prescriptions, and postdischarge outcomes were equivalent among all race/ethnic groups.Conclusion. Despite pronounced race/ethnicity-based differences in chronic asthma, all racial/ethnic groups exhibited similar acute asthma severity, ED management, and course. However, given that black and Hispanic children exhibited much higher admission histories and past ED use, the equivalence in inhaled corticosteroid prescriptions on discharge is a disconcerting pattern that mirrors previous literature on outpatient prescription practices. In addition to barriers attributable to socioeconomic factors, health care providers and policy makers should target equalizing deficiencies in preventive medication prescription practices. Pediatrics 2003;111:e615-e621. URL: http://www.pediatrics.org/cgi/content/full/111/5/e615; asthma, children, socioeconomic status, race, ethnicity, quality of care.ABBREVIATIONS. ED, emergency department; MARC, Multicenter Airway Research Collaboration; PCP, primary care provider; SES, socioeconomic status. D espite effective therapies, asthma prevalence, morbidity, and mortality among children is increasing in the United States, and the burden is being borne disproportionately by blacks and Hispanics. Previous studies have focused primarily on racial/ethnic disparities noted in chronic care and management and have relied heavily on archival or billing data. To examine further the role of race/ ethnicity on asthma among children who present to the emergency department (ED), we examined prospective data from the Multicenter Airway Research Collaboration (MARC). On the basis of previous research, we hypothesized that black and Hispanic children with asthma would 1) exhibit more severe respiratory distress on arrival to the ED, 2) receive less adequate care while in the ED, 3) be admitted more often from the ED during their index visit, and 4) be more likely to relapse or have continued symptoms during the 2 weeks postdischarge. We further hypothesized that sociodemographic factors (including parental education, income, and insurance status) and access to a primary care provider (PCP) would play an important r...
