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Validity of the HEDIS criteria to identify children with persistent asthma and sustained high utilization

Anne L Fuhlbrigge1, Vincent J Carey, Jonathan A Finkelstein

  • 1Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. anne.fuhlbrigge@channing.harvard.edu

The American Journal of Managed Care
|May 19, 2005
PubMed

Insights

The Health Plan Employer Data and Information Set (HEDIS) measure for asthma quality may be less valid due to a two-year gap. Extending the observation period to two years weakened the association between controller medication and emergency visits.

Area of Science:

  • Pediatric Pulmonology
  • Healthcare Quality Measurement
  • Health Services Research

Background:

  • The Health Plan Employer Data and Information Set (HEDIS) is a key performance measure for asthma care.
  • Criticism exists regarding HEDIS's validity due to a potential misalignment caused by a delay between patient classification and outcome assessment.
  • This delay may weaken the measure's ability to accurately reflect quality of care.

Purpose of the Study:

  • To assess the robustness of the association between the HEDIS performance measure and asthma-related emergency department visits.
  • To evaluate this association when the classification and outcome assessment periods are extended to two years.

Main Methods:

  • A cohort of 2766 children (aged 3-15) with asthma diagnoses across three managed care organizations was identified.
  • Data from July 1996 to June 1999 were analyzed, requiring at least two consecutive years of enrollment.
  • Children's adherence to HEDIS criteria for persistent asthma and controller medication dispensing were examined.

Main Results:

  • A significant proportion of children (24-28%) did not consistently meet HEDIS criteria for persistent asthma over the two-year observation period.
  • The previously observed protective association between controller medication dispensing and reduced asthma-related emergency department visits was not statistically significant when the observation period was extended to two years (OR, 0.7; 95% CI, 0.4-1.2).

Conclusions:

  • The variable nature of childhood asthma may impact the utility of the HEDIS measure for assessing healthcare quality.
  • A closer temporal relationship between the identification of the target population and the performance assessment is recommended for improved validity.
Abstract

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