Methods: Florida Medicaid retrospective claims data (1997-2009) were analyzed to compare the likelihood of receiving targeted comorbid allergy-related respiratory conditions among AR-diagnosed (ICD-9 477.x) children (age <18 years) and adults (age ≥18 years). Targeted comorbidities included strep throat (ICD-9 034.x), conjunctivitis (372.x), otitis media (381.x-382.x), acute respiratory infections (460.x-466.x), other diseases of the upper respiratory tract (470.x-476.x and 478.x), pneumonia/influenza (480.x-488.x), chronic obstructive pulmonary disease/allied conditions (490 -496), asthma (ICD-9 493.x), and atopic dermatitis (691.8).
Results: Overall rates of AR were significantly higher for children than adults (8% versus 3%, p<0.0001). On average, AR-diagnosed patients had significantly more comorbid allergy-related respiratory conditions than nonAR-diagnosed patients (children, 3.7 ±1.9 versus 1.2 ±1.7 p<0.0001; adults, 2.6 ±1.7 versus 0.5 ±1.0, p<0.0001). Compared to nonAR-diagnosed patients, the likelihood of receiving the following diagnoses among AR-diagnosed children and adults, respectively, were: 13 and 15 times greater for acute respiratory infection; 6 and 9 times greater for otitis media; 6 and 8 times greater for asthma; 6 and 12 times greater for upper respiratory infection; 5 and 8 times greater for conjunctivitis; 5 times greater (both children and adults) for chronic obstructive pulmonary disease/allied conditions; 5 and 8 times greater for strep throat; 4 and 3 times greater for pneumonia/influenza; and 4 and 9 times greater for atopic dermatitis. Differences between AR- versus nonAR-diagnosed groups and between children and adults were significant at the p<0.001 level.
Conclusions: Compared to their counterparts who were not diagnosed with AR, children and adults with AR had a significantly greater likelihood for receiving any targeted comorbid allergy-related respiratory condition. Likelihood estimates, which were 3 to 15 times greater for AR-diagnosed patients, varied significantly for children and adults by specific comorbid condition. Given a diagnosis of AR, the likelihood for comorbid respiratory infection, asthma, otitis media, conjunctivitis, atopic dermatitis and strep throat was substantially greater for adults; the likelihood for pneumonia/influenza was greatest for children; and the likelihood for chronic obstructive pulmonary disease/allied condition was roughly equivalent for the two age groups.