ASSOCIATION OF ASTHMA CONTROL WITH HEALTH CARE UTILIZATION A PROSPECTIVE EVALUATION

Similar documents
Asthma Population Management: Identifying Persistent Asthma, Defining High Risk Asthma, and Measuring Quality of Asthma Care

Association of Asthma Control with Health Care Utilization and Quality of Life

Using an Asthma Control Questionnaire and Administrative Data To Predict Health-Care Utilization*

Type 2 Diabetes: Incremental Medical Care Costs During the 8 Years Preceding Diagnosis. Diabetes Care 23: , 2000

2014 Physician Quality Reporting System Data Collection Form: Asthma (for patients aged 5-64)

Asthma is a common chronic medical condition that is associated

Rapid Effects of Inhaled Corticosteroids in Acute Asthma Gustavo J. Rodrigo, MD.

Hospital Discharge Data

Measure #383 (NQF 1879): Adherence to Antipsychotic Medications For Individuals with Schizophrenia National Quality Strategy Domain: Patient Safety

Modular Program Report

Detroit: The Current Status of the Asthma Burden

2017 HEDIS IET Measure

July, Years α : 7.7 / 10, Years α : 11 / 10,000 < 5 Years: 80 / 10, Reduce emergency department visits for asthma.

Quality Performance Measurement and Use of Health Information Technology in Critical Access Hospitals

Reducing COPD Exacerbation Readmissions in a Community-Based Teaching Hospital

Measure #383 (NQF 1879): Adherence to Antipsychotic Medications For Individuals with Schizophrenia National Quality Strategy Domain: Patient Safety

PATIENT-IMPACT SCORECARD

Asthma Among Minnesota Health Care Program Beneficiaries

Comprehensive Research Plan: Inhaled corticosteroids + long-acting beta agonists (ICS+LABA) for the treatment of asthma

ASTHMA CARE FOR CHILDREN BASKET OF CARE SUBCOMMITTEE Report to: Minnesota Department of Health. June 22, 2009

VIDA SIGNIFICANT ASTHMA EXACERBATION (Visits 2-10, 88 and 90-92)

The Impact of Cardiovascular Disease on Medical Care Costs in Subjects With and Without Type 2 Diabetes

HEDIS Quick Reference Guide Updated to reflect NCQA HEDIS 2016 Technical Specifications

Cost-Motivated Treatment Changes in Commercial Claims:

CHAPTER 7 SECTION 24.1 PHASE I, PHASE II, AND PHASE III CANCER CLINICAL TRIALS TRICARE POLICY MANUAL M, AUGUST 1, 2002 MEDICINE

Epidemiology of First-Episode Psychosis in large, integrated healthcare systems

Modular Program Report

Optimising asthma management in high risk patients

LOUISIANA MEDICAID PROGRAM ISSUED: 02/01/12 REPLACED: 02/01/94 CHAPTER 5: PROFESSIONAL SERVICES SECTION 5.1: COVERED SERVICES PAGE(S) 6

PATIENT INFORMATION FORM

The prevalence and severity of chronic asthma have

Clinical Quality Measures Summary of Upcoming Enhancements

QBPC Claims Based Provider Quick Reference Guide

HUSKY Health Benefits and Prior Authorization Requirements Grid* Behavioral Health Partnership Effective: January 1, 2012

Trends in Glucocorticoid-Induced Osteoporosis Management Among Seniors in Ontario,

Section II: Detailed Measure Specifications

Key Quality of Care Measures. Blue Cross Blue Shield of Michigan Traditional, PPO and POS Members. Fourth Quarter 2003

Optum Research Database Proportion of asthma patients with prescription fills for rescue and controller medications by year,

Leeds West CCG Paediatric asthma project. January 2015-January 2017

Long Term Care Formulary RS -29

COSTS OF DIABETES IN DEVELOPING COUNTRIES

Blue Cross and Blue Shield of New Mexico and Lovelace Health Plan Transactions Frequently Asked Questions

and will be denied as not medically necessary** if not met. This criterion only applies to the initial

Policy Evaluation: Step Therapy Prior Authorization of Combination Inhaled Corticosteroid / Long-Acting Beta-Agonists

Value of Hospice Benefit to Medicaid Programs

Study Exposures, Outcomes:

Predicting, Preventing and Managing Asthma Exacerbations. Heather Zar Department of Paediatrics & Child Health University of Cape Town South Africa

NCC Pediatrics Continuity Clinic Curriculum: Medical Home Module 2 Well Visits

«Impact of a pharmaceutical intervention to improve adherence of inhaled medication in asthma and COPD patients»

NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE. Measure Information Form Collected For: CMS Outcome Measures (Claims Based)

NQF-ENDORSED VOLUNTARY CONSENSUS STANDARD FOR HOSPITAL CARE. Measure Information Form Collected For: CMS Outcome Measures (Claims Based)

Chapter 18 Section 2. EXPIRED - Department Of Defense (DoD) Cancer Prevention And Treatment Clinical Trials Demonstration

Peak Expiratory Flow Rate (PEFR) for ED Management of Acute Asthma Exacerbation

Asthma: Evaluate and Improve Your Practice

Cardiovascular Health and Diabetes Screening for People with Schizophrenia

HEDIS. Quick Reference Guide. For more information, visit

2012 Chronic Respiratory. Program Evaluation. Our mission is to improve the health and quality of life of our members

Building a learning healthcare system for suicide prevention

Anesthesia Reimbursement

2017 Blue Cross and Blue Shield of Louisiana

Disease Management. Measures At A Glance

Optimal Asthma Control Data Specifications

Adjustment of Inhaled Controller Therapy of Asthma in the Yellow Zone, Based on the Inhaler Product Used in the Green Zone Age 16 Years and Older

Disclosure. Case. Objectives. Case Continued. Inhalers. Asthma: A GINA Update to the NAEPP 2007 Guidelines 1/20/2015

Arkansas Health Care Payment Improvement Initiative Congestive Heart Failure Algorithm Summary

شءءذص Primary Care Respiratory. Tools to help you stratify people with asthma who should be offered a priority review

HEDIS. Quick Reference Guide. For more information, visit

Learning Objectives. Guidance Hierarchy. AHA Coding Clinic Update

Title of Project: NHS Dumfries & Galloway Respiratory Bundle Asthma: Bronchodilator Overuse Review April 2015

Developed By Name Signature Date

Outpatient Therapy Services

The National Asthma Education and Prevention Program s

Counseling to Prevent Tobacco Use

UnitedHealth Premium Designation Program Case-mix Adjusted Benchmarks with Severity or Risk Adjustment

MULTICARE Health System Care of the Adult Chronic Obstructive Pulmonary Disease (COPD) Patient

2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Process

See Important Reminder at the end of this policy for important regulatory and legal information.

Performance Improvement Projects Related to CDC s 6 18 Initiative: A Scan of External Quality Review Organization Reports

Asthma Coding Fact Sheet for Primary Care Pediatricians

Identifying Adult Mental Disorders with Existing Data Sources

Kaiser Permanente s Experience in Coverage and Conduct of Oncology Clinical Trials

FY17 SCOPE OF WORK TEMPLATE. Name of Program/Services: Medication-Assisted Treatment: Buprenorphine

Issue Brief. Eliminating Adult Dental Benefits in Medi-Cal: An Analysis of Impact. Introduction. Background

SYNOPSIS A two-stage randomized, open-label, parallel group, phase III, multicenter, 7-month study to assess the efficacy and safety of SYMBICORT

Clinical Policy: Fluticasone/Salmeterol (Advair Diskus, Advair HFA) Reference Number: CP.PMN.31 Effective Date: 08/16 Last Review Date: 08/17

Hospice Metrics Using Medicare Data to Measure Access and Performance for Hospice and Palliative Care

2017 Chronic Respiratory. Program Evaluation. Our mission is to improve the health and quality of life of our members

Healthy People 2010 Asthma Objectives December 2009 Update

Key Findings and Recommendations from the

Validating a computable phenotype: Should results change a trial s primary outcome?

GSK Clinical Study Register

Depression and Anxiety Relative Risks in Women Newly Diagnosed with Vulvovaginal Atrophy and Dyspareunia

2013 Chronic Respiratory. Program Description. Our mission is to improve the health and quality of life of our members

Pharmacy Medical Policy IgE Receptor Binding Inhibitors

Claim Submission. Agenda 1/31/2013. Payment Basics

SUMMARY TABLE OF MEASURES, PRODUCT LINES AND CHANGES

Improving asthma outcomes in large populations

#1 cause of school absenteeism in children 13 million missed days annually

Zhao Y Y et al. Ann Intern Med 2012;156:

Approved Care Model for Project 3dii: Expansion of the Home Environmental Asthma Management Program

Transcription:

Online Supplement for: ASSOCIATION OF ASTHMA CONTROL WITH HEALTH CARE UTILIZATION A PROSPECTIVE EVALUATION METHODS Population The Northwest Region of Kaiser Permanente (KPNW) is a large, federally qualified, groupmodel health maintenance organization (HMO) located in Portland, Oregon. KPNW has approximately 450,000 members, whose demographic and socioeconomic characteristics are similar to those of the area population as a whole (E1). The present analysis is based on the results of a survey sent to a subset of KPNW members, aged 18 and older, who had two or more antiasthma medication dispensings in 1996 and/or a hospital or ED visit for asthma in 1994, 1995, or 1996. In addition, all individuals had current KPNW health plan coverage as of June 30, 1997. A total of 13,964 members met these criteria. We surveyed this population between August and September 1997. Everyone received a brief, two-page screening questionnaire (ATAQ, see below). In addition, approximately onequarter also received generic and asthma-specific quality of life questionnaires. Sixty-two percent (8,658) of those we mailed to returned a completed questionnaire, and of these, 60% (5,172) reported that they had a doctor diagnosis of asthma, had taken asthma medications within the past 12 mo, and had answered all the questions relevant for the control index. These constituted the target population for the present analysis. Among these 5,172 individuals, 93% (4,795) had 6 or more mo of KPNW health plan eligibility in the following year, 1998, and thus were included in the analysis. The average duration of health plan eligibility during 1998 for this latter group was 11.8 mo, and 95% had a full 12 mo of eligibility. E1

Survey Instrument The Asthma Therapy Assessment Questionnaire (ATAQ) is a brief, self-administered questionnaire designed to assess level of asthma control and identify possible disease management problems. To assess asthma control, the questionnaire asks about: (1) selfperception of asthma control (did you feel that your asthma was well-controlled?); (2) missed work, school, or normal daily activities due to asthma; (3) nighttime waking due to asthma symptoms; and (4) overuse of quick relief inhaler medication, defined here as more than 12 puffs of a reliever medication on any day in the past 4 wk. With the exception of quick reliever use, which involves two questions, each control dimension is assessed using a single question. Respondents are then graded as either having or not having a control problem in each of these dimensions, and the number of control problems is summed to provide an index ranging from 0 to 4. Although the ATAQ instrument assesses these problems relative to both the last year and the last 4 wk, the analysis reported here is based on 4-wk recall responses. Thus, asthma control as reported in this paper reflects short-term asthma control. Copies of the complete ATAQ instrument and detailed coding instructions are available from Merck & Co. Contact Leona Markson at: leona_markson@merck.com. Health Care Utilization The health care utilization data used for this analysis were derived from a number of large administrative and clinical databases maintained by KPNW and briefly summarized below. Although we define acute care as hospitalizations, ED care, and other acute care provided in the regular outpatient clinics, we recognize that some of this is actually convenience care. Similarly, some of what we call routine care may actually be for an acute exacerbation of symptoms. The distinction, nonetheless, has face validity and should generally be accurate. E2

Inpatient database. Both KPNW and its alliance hospitals use an automated inpatient scheduling system that serves as the basis for the discharge abstract. We counted as inpatient admissions all hospitalizations occurring in 1998 for which the primary discharge diagnosis was asthma (International Classification of Diseases, Ninth Revision [ICD-9] code = 493.x). Emergency department database. Data for ED care are recorded in a separate database from that used for inpatient care. Primary diagnosis is not entered as an ICD-9 code, but instead is captured in an open text field. We modified a previously developed search string that appears to have good sensitivity and specificity for detecting asthma. Only true ED visits were included in the category of ED care. Some visits to the KPNW urgent care clinic are also captured in this database, but were included in the category other acute care. EpicCare database. EpicCare (EPIC) is KPNW s automated clinical information system. This computerized medical record database includes information on all clinic-based outpatient contacts occurring within KPNW. These contacts are all coded using the ICD-9 classification system, although this classification is done by clinic staff using text strings rather than after the fact by trained nosologists. Thus, for example, a physician will select the diagnosis asthma from a drop-down menu, which is then coded internally as 493. EPIC does not formally distinguish between primary and secondary diagnoses. We therefore considered all contacts with an asthma diagnosis in any of the first 10 diagnosis fields to be asthma utilization. Among the visits so identified, asthma was listed as the first diagnosis 63% of the time. Visits conducted by phone were also counted. Outpatient visits for asthma occurring at the urgency care clinic, as well as other outpatient visits at which a patient received E3

nebulizer treatment, were classified as other acute asthma care. All other EPIC contacts were classified as routine care. Claims database. Clinical database (OSCAR) is KPNW s automated claims processing system for recording covered services (generally inpatient and ED care) provided by non-kp facilities. Because any given health care encounter may generate several OSCAR billing records, each with its own primary diagnosis, we classified an encounter as an asthma visit if asthma was listed as the primary diagnosis on any of the 10 largest billings. Outside hospitalizations are also included in the inpatient database; we used OSCAR to capture only outside ED care. Overlapping health care utilization information. We were careful not to overcount encounters. Where such records did exist, we used OSCAR to classify ED care, because OSCAR uses ICD-9 codes versus a text field for the ED database. For other outpatient care, the order of databases from which diagnosis data was taken was EPIC first, inpatient next, and OSCAR last. Outpatient pharmacy database. All medications dispensed at KPNW outpatient pharmacies are recorded in a common database. We used this database to create several summary variables, including (1) total number of antiasthma dispensings (not including prednisone); (2) total number of β-agonist dispensings (inhalers and nebulizers); (3) total number of prednisone dispensings; and (4) the ratio of β -agonist dispensings to inhaled corticosteroid dispensings. Ratios were not calculated for other controller medications, because inhaled corticosteroids were the primary controller therapy used during this time. Although these variables were not used to define any of the health care utilization categories previously described, they were used in some of our prediction equations as noted in the main text. E4

Eligibility Data We used KPNW membership records to compute the number of person-months of eligibility for each individual during 1998. Person-months were then divided by 12 to get person-years, and this information was used to calculate rates of occurrence of various health care utilization outcomes. Only those individuals with at least 6 mo of eligibility in 1998 were included in the analyses. Statistical Methods Rates of health care utilization are expressed per 1,000 person-years of observation and are computed as the total number of events of interest (e.g., hospitalizations), divided by the total number of person-years of observation, X1,000. For these calculations, total events are counted in the numerator, regardless of whether they represent repeat occurrences for given individuals. Proportions of individuals with different types of health care utilization were computed as the number of individuals with such utilization during 1998 divided by the number of individuals. Reference E1. Freeborn DK, Pope CR. Promise and performance in managed care, 1st edition. Johns Hopkins University Press; Baltimore, MD: 1994, p. 1 170. E5