Health care utilization in patients with moderate to severe asthma: does payor status predict usage?
Collier, KC
Collier, KC
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Abstract
Background: To examine the association between insurance status and asthma-related health care utilization among adults with moderate to severe asthma. Methods: We conducted a cross-sectional analysis of data from the Asthma BMI Baseline Study (ABBS) and Trial of Roflumilast in Asthma Management (TRIM) (n = 141). Insurance status was categorized as full insurance coverage (no co-pay) and not fully insured (co-pay or fully out of pocket). Binomial stepwise logistic regression evaluated prednisone use, urgent care visits, hospital visits, overnight stays, and ICU admission. Models adjusted for age, sex, race, BMI (step 1), then education and income (step 2). Results: In step 1, those with medical coverage were less likely to visit urgent care (OR = 0.196, 95% CI: 0.060-0.637, P = 0.007). After full adjustment, no significant differences were observed. Those with a college education were less likely to require urgent care (OR = 0.107, 95% CI: 0.018-0.654, p = 0.015). Higher BMI was associated with risk of overnight admission (OR = 4.411, 95% CI: 1.056-18.424, P = 0.042). Conclusion: Payor status was not independently associated with health care utilization. Full coverage was associated with fewer urgent care visits, while higher BMI with increased risk of hospitalization. Policy should emphasize clinical and socioeconomic factors influencing care rather than insurance coverage alone.
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Date
1/1/2026
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Graduate Student
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Poster
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Public Health
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Larner College of Medicine
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Clinical Science