Understanding of Asthma Management: Conclusions

Finally, a distinctive barrier was the parental perception on differences in quality of care, due to the use of Medicaid insurance. In some cases, parents believed that certain limitations (ie, the prescription of generic vs brand name medications, poor access to administrative assistance, limits on refills) were due to the fact that they had Medicaid insurance, as opposed to limitations imposed on both Medicaid-insured and non-Medicaid-insured patients. Asthma self-management education should be targeted to improve control among high-risk popula-tions. Medicaid-insured families face unique barriers related to income and insurance limitations as well as other issues faced by non-Medicaid-insured children with asthma.
The Medicaid-insured caregivers in our sample demonstrated a high level of asthma knowledge, but like other non-Medicaid-insured caregivers there are gaps between knowledge and behavior. A specific gap was seen in the caregiver’s level of selfefficacy to control exposure to asthma triggers, monitor their child’s asthma symptoms, and know how to change medications when their child’s asthma symptoms change, all of which impact compliance with asthma management strategies. Primary care physicians can support such patients and their families by moving beyond “one-shot” education initiatives to the provision of serial asthma education, targeting the reinforcement of home management strategies, appropriate asthma monitoring and treatment decisions, and openly discussing parental concerns regarding asthma care. this
There were barriers to asthma care that may be specific to Medicaid-insured patients regarding difficulty in maintaining continuity of care and perceived differences in asthma care from health-care providers or medical staff. As a result, it may be helpful for physicians to employ strategies that demonstrate to patients that decisions for care are not based on the type of patient insurance, such as Medicaid insurance.

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