Jeremy Olson writes about children and families, and is an overscheduled father of two. His blog tackles the best and worst of parenting, families, health and love. He wants to hear from you - what's going on in your house?
School-aged children received less asthma medication, on average, when their parents had to pay more of the cost out of pocket, according to a study released this afternoon in the influential Journal of the American Medical Association.
A research team led by the University of Minnesota's Pinar Karaca-Mandic reviewed insurance claims for more than 8,000 asthmatic children ages 5 to 18 in the U.S. Not only did these children take less medication when their families bore higher out of pocket costs, they also ended up in the hospital more with asthma-related complications.
"These children aren't getting the medicine they need, which can spell serious long-term trouble for them," Karaca-Mandic said. "The results signal one of the true impacts of rising insurance costs."
The change wasn't dramatic. Even when parents had low out of pocket costs ($100 per year), they only obtained enough asthma medication to cover 41.7 percent of the recommended daily doses for their school-aged children. When parents bore higher out of pocket costs ($190 per year), their children only received 40.3 percent of the recommended medication.
Considering the nominal difference in the high and low cost groups, it was surprising to see any difference at all, Karaca-Mandic said. She was also surprised that so many children -- regardless of cost -- weren't taking preventive asthma medications on more of a daily basis.
The study found a significant impact when examining the rate of school-aged children admitted to hospitals for asthma complications. Among families with higher out of pocket drug costs, the rate of hospitalization was 2.4 children per 100. Among families with lower costs, the rate was only 1.7 children per 100.
Interestingly, there was no difference among the cost groups in the rate of ER visits among asthmatic children. Nor did cost have any impact on medication usage by asthmatic children younger than five. Karaca-Mandic said the consequences of unmanaged asthma can be more severe in infants and toddlers, so parents might be more diligent about giving their children daily doses of medication -- regardless of cost.
Other studies have shown that adults skimp on their own asthma medication when costs are higher. But Karaca-Mandic didn't expect cost to have such a difference on medication rates in children. The study focused on children covered by private insurance, which Karaca-Mandic said is significant because so much research focuses on costs and medication usage among people with asthma who are uninsured or enrolled in public programs.
"We kind of take the privately insured children for granted and yet all these studies are telling us that all of these families are paying more and more out of pocket" and struggling with the cost, she said. "We really need to be thinking about policy and practice interventions to manage asthma care and to prevent these hospitalizations."
Skimping on asthma meds didn't save any money -- at least on average -- because families ended up paying more when their children needed to be hospitalized.
Readers: This is a return to form for Daddy-O. A reporting assignment cut down on my blogging this month, but look for more daily posts on compelling children and family issues in the coming days. And send me your suggestions! What social issues do you think demand more attention?