Asthma population management: development and validation of a practical 3-level risk stratification scheme

Area of Science:

• Pulmonary Medicine
• Health Services Research
• Biostatistics

Background:

• Asthma emergency hospitalizations represent a significant healthcare burden.
• Effective risk stratification is crucial for proactive asthma management.
• Administrative data offers a scalable solution for identifying at-risk populations.

Purpose of the Study:

• To develop and validate a practical risk stratification scheme for identifying patients at high, medium, and low risk of emergency asthma hospital care.
• To utilize administrative data for this risk stratification process.
• To enable targeted interventions for asthma patients.

Main Methods:

• Retrospective cohort study design.
• Logistic regression analysis of administrative data predictors (previous year's emergency care, beta-agonist canister use, oral corticosteroid use).
• Validation in separate training and testing datasets.

Main Results:

• A simple risk score was developed, categorizing patients into high, medium, and low risk.
• High-risk patients were identified by prior emergency care or high medication use (PPV 12.9-22.0%, Sensitivity 24.8-25.4%).
• Medium-risk patients (no prior emergency care but high medication use) represented an additional 28.3-32.6% requiring future emergency care.

Conclusions:

• The developed risk stratification scheme is a practical and useful tool for identifying patients at increased risk of emergency asthma hospital care.
• Administrative data can be effectively leveraged for asthma risk stratification.
• This scheme supports targeted interventions to reduce asthma-related emergency visits.