The purpose of this study is to explore the access patterns of inner-city children with asthma and to identify how current health care systems facilitate or impede the use of health care resources by this population.
Specific aims of this study are to 1) identify the individual predisposing attributes that facilitate or impede patients from accessing primary health care for asthma management, 2) identify the enabling attributes of health care systems that facilitate or impede patient access to primary care for asthma management, and 3) examine the need attributes as subjectively experienced by patients and as objectively experienced by health care providers that trigger access to urgent, emergent, and primary health care services. Qualitative design methods will be employed in this research design in order to gain an in-depth understanding of patient experiences; qualitative interviews will be objectively compared with medical records and health system data. Data collection methods will include: semi-structured interviews, focus groups, asthma severity measures, resource utilization, and demographic data. The sample will include parents of children seeking asthma care and health care providers providing care in an urban hospital and in urban community health clinics. The significance of this study is to gain a better understanding the pattern of health care utilization unique to inner-city children with asthma. Identifying attributes that facilitate or impede resource utilization will allow system redesign and policy changes to better address the access barriers experienced by this vulnerable population.
