Trends in Health Care Utilization Among United States Children With Eczema by Age, Sex, Race, and Hispanic Ethnicity: National Health Interview Survey 2006-2018.

Abstract

Background: Higher health care utilization has been proven among US children with eczema than those without, but disparities may exist among sociodemographic subgroups. Objective: To determine health care utilization trends among children with eczema across sociodemographic factors. Methods: We included children (0-17 years old) from the US National Health Interview Survey 2006-2018. We calculated the survey-weighted health care utilization by determining proportion of children attending a well-child checkup, seen by a medical specialist, and seen by a mental health professional in the previous 12 months for children with and without eczema, by race (white, black, American Indian/Alaska Native, Asian, and multiracial), Hispanic ethnicity (yes/no), age (0-5, 6-10, 11-17), and gender (male/female) subgroups using SPSS complex samples. Joinpoint regression was used to estimate piecewise log-linear trends in the survey-weighted prevalence, annual percentage change, and disparities between subgroups. Results: We included 149,379 children-there was higher health care utilization in children with eczema than those without. However, when comparing the average annual percentage change (AAPC), white children had a significantly higher AAPC of "attending a well-child checkup" than black children. In addition, only white children showed a significantly increasing trend in being "seen by a medical specialist," whereas all other minority race subgroups had stagnant trends. For those "seen by a mental health professional," there were increasing trends only in the male and non-Hispanic subgroups out of all the sociodemographic subgroups. Conclusion: Improving awareness among primary care physicians to refer children with moderate-to-severe eczema to medical specialists (eg, allergists, dermatologists, and mental health/attention-deficit/hyperactivity disorder professionals) when necessary could improve quality of life and reduce emergency department visits-especially among minority race, Hispanic, and female children.