AUTHOR=Lee Won Seok , Hwang Jae Kyoon , Ryu Jiin , Choi Young-Jin , Oh Jae-Won , Kim Chang-Ryul , Han Man Yong , Oh In Hwan , Lee Kyung Suk 

TITLE=The relationship between childhood asthma and socioeconomic status: a Korean nationwide population-based study

JOURNAL=Frontiers in Public Health

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1133312

DOI=10.3389/fpubh.2023.1133312

ISSN=2296-2565

ABSTRACT=<sec><title>Purpose</title><p>This study aimed to investigate associations of socioeconomic status (SES) with asthma exacerbation and asthma-related hospital utilization factors among children with asthma in the Republic of Korea.</p></sec><sec><title>Methods</title><p>This study retrospectively analyzed population-level data from the Korean National Health Insurance Service, collected from 2013 through 2019. SES was classified into five categories according to the national health insurance premiums quantiles (0 [lowest] to 4 [highest]). The hazard ratios (HRs) for asthma exacerbation, emergency department (ED) visits, hospital admission, and intensive care unit (ICU) admission were analyzed with respect to SES.</p></sec><sec><title>Results</title><p>Among the five SES groups, SES group 0 (medical aid), had the highest tallies and proportions of children who experienced asthma exacerbations (<italic>n</italic> = 1,682, 4.8%), ED visits (<italic>n</italic> = 932, 2.6%), hospital admission (<italic>n</italic> = 2,734, 7.7%) and ICU admission (<italic>n</italic> = 14, 0.04%). Compared with SES group 4, SES group 0 had adjusted HRs of 3.73 (<italic>p</italic> = 0.0113) and 1.04 (<italic>p</italic> &lt; 0.0001) for ventilator support/tracheal intubation and administration of systemic corticosteroids, respectively. Relative to group 4, the adjusted HRs for ED visits, hospital admission, and ICU admission in group 0 were 1.88 (<italic>p</italic> &lt; 0.0001), 2.20 (<italic>p</italic> &lt; 0.0001), and 7.12 (<italic>p</italic> &lt; 0.0001), respectively. In the survival analysis, group 0 had a significantly higher risk of ED presentation, hospital admission, and ICU admission than the other groups (log-rank <italic>p</italic> &lt; 0.001).</p></sec><sec><title>Conclusion</title><p>Compared with children of higher SES, those in the lowest SES group had increased risk of asthma exacerbation, hospital admission, and receiving treatment for severe asthma symptoms.</p></sec>