Black children with asthma are less likely to be transported to a hospital by emergency medical services (EMS) despite being more likely to have severe asthma episodes compared with white children, according to a study.
Published in Prehospital Emergency Care, the study sought to understand how prehospital treatment and hospital transport for children with asthma differs by patient race, ethnicity and socioeconomic status. Researchers hope to use the study findings to improve equitable pediatric asthma treatment, according to a Medical News article.
“We have a lot of data on hospital management of childhood asthma but very little information to show how well we are treating asthma in the prehospital environment or if there are disparities,” said lead study author Sylvia Owusu-Ansah, MD, a pediatric emergency medicine physician and EMS medical director at UPMC Children’s Hospital of Pittsburgh, in an article in Medical News.
For the study, Owusu-Ansah and her team looked at how EMS personnel manage and treat asthma in a prehospital setting. Utilizing a national database, the team analyzed 5,266 EMS encounters with children ages 2 through 17. About 53% of children were non-Hispanic Black, and 34% were non-Hispanic white.
The study found that Black children were most likely to receive breathing treatments called bronchodilators, usually indicating severe asthma attacks requiring additional treatment, but despite this, Black children were less likely to be taken to the hospital compared with white children.
“Patients may need to be transported to a hospital for further evaluation and care, and we don’t want people avoiding that follow-up care if it’s crucial to supporting their health and wellness,” said Owusu-Ansah.
Researchers said many factors can play into transport decisions, including distrust of health care or patients thinking they are less sick than they are.
Owusu-Ansah emphasizes the need to educate emergency personnel on how social determinants of health, such as affordable health care, housing, food security and environmental exposures, impact patients’ health.
“The prehospital setting is a unique environment where health care providers can engage with patients in ways that aren’t possible in the hospital,” Owusu-Ansah said. “As first responders, EMS has the first look at the patient and their home, so they can observe whether there is mold or other factors that contribute to a patient’s illness. A patient may not share that information with their doctor. But EMS can pick up on small details that may be important when treating a patient and have huge opportunity to make a difference.”