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Asthma quality-of-care markers using administrative data
Michael Schatz1, Randy Nakahiro, William Crawford
1Department of Allergy, Kaiser-Permanente Medical Center, San Diego, Los Angeles, CA 92111, USA. michael.x.schatz@kp.org
Chest
|October 21, 2005
Summary
Asthma medication use may indicate severity, not quality of care. A controller to total asthma medication ratio of 0.5 or higher best identified quality of asthma care.
Area of Science:
- Pulmonary Medicine
- Health Services Research
Background:
- Asthma quality of care is crucial for patient outcomes.
- Identifying reliable markers for asthma quality of care is essential for improving patient management and reducing healthcare costs.
Purpose of the Study:
- To evaluate the relationship between potential asthma quality-of-care markers and subsequent emergency hospital care.
- To determine which markers best reflect asthma quality of care.
Main Methods:
- Retrospective analysis of administrative data from a managed care organization.
- Inclusion of asthmatic patients aged 5 to 56 years.
- Analysis of controller medication canisters, controller/total asthma medication ratio, and beta-agonist canister dispensing as quality markers.
- Outcome measure was emergency department visit or hospitalization for asthma.
Main Results:
- Increased controller medication use was associated with higher risk of emergency care.
- A controller/total asthma medication ratio of >= 0.5 and fewer than six beta-agonist canisters were associated with decreased risk of emergency care.
- These associations persisted after adjusting for baseline asthma severity.
Conclusions:
- Controller and beta-agonist medication use may serve as indicators of asthma severity rather than quality of care markers in large populations.
- A controller to total asthma medication ratio of 0.5 or greater appears to be the most effective quality-of-care marker identified in this study.