Abstract

Recent research has shown that asthma admission rates for children vary widely across geographic areas and have increased nationally for the past decade. The overall goals of this FIRST award research plan are to study three possible, but yet unproved, influences of pediatric asthma hospitalization rates - diagnostic substitution, different systems of medical care, and asthma medication use. Specific hypotheses regarding these factors will be tested in two different data sets: (1) ecologic studies of trends and area variations of the children residing in the contiguous states of Maine, New Hampshire, and Vermont for 1980 - 1994 (2) retrospective cohort analyses of children enrolled at a staff model HMO, Group Health Cooperative of Puget Sound for 1977 - 1994. These studies will utilized detailed information regarding area and individual """"""""exposure"""""""" to differing systems of health care and asthma medications, controlling for socioeconomic status. The results from these studies will have direct relevance to the clinical care and development of public policy for children with asthma.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
First Independent Research Support & Transition (FIRST) Awards (R29)
Project #
5R29HL052076-02
Application #
2229220
Study Section
Epidemiology and Disease Control Subcommittee 2 (EDC)
Project Start
1994-04-01
Project End
1998-02-28
Budget Start
1995-04-01
Budget End
1996-02-29
Support Year
2
Fiscal Year
1995
Total Cost
Indirect Cost

  Institution

Name
Dartmouth College
Department
Pediatrics
Type
Schools of Medicine
DUNS #
041027822
City
Hanover
State
NH
Country
United States
Zip Code
03755

  Publications

Goodman, D C; Wennberg, J E (1999) Maps and health: the challenges of interpretation. J Public Health Manag Pract 5:xiii-xvii
Goodman, D C; Lozano, P; Stukel, T A et al. (1999) Has asthma medication use in children become more frequent, more appropriate, or both? Pediatrics 104:187-94
Goodman, D C; Stukel, T A; Chang, C H (1998) Trends in pediatric asthma hospitalization rates: regional and socioeconomic differences. Pediatrics 101:208-13
Goodman, D C; Fisher, E; Stukel, T A et al. (1997) The distance to community medical care and the likelihood of hospitalization: is closer always better? Am J Public Health 87:1144-50
Goodman, D C; Fisher, E S; Bubolz, T A et al. (1996) Benchmarking the US physician workforce. An alternative to needs-based or demand-based planning. JAMA 276:1811-7
Goodman, D C; Littenberg, B; O'Connor, G T et al. (1996) Theophylline in acute childhood asthma: a meta-analysis of its efficacy. Pediatr Pulmonol 21:211-8