Evaluation of a medicaid asthma disease management program

Area of Science:

• Health Services Research
• Public Health
• Chronic Disease Management

Background:

• Asthma management programs aim to improve patient outcomes and reduce healthcare utilization.
• Medicaid populations often face challenges in accessing consistent asthma care.
• Effective disease management (DM) strategies are crucial for controlling chronic respiratory conditions.

Purpose of the Study:

• To evaluate the 1-year outcomes of an asthma disease management program in an Oregon Medicaid population.
• To assess the program's impact on healthcare utilization and asthma severity.
• To identify factors influencing changes in asthma severity within the program.

Main Methods:

• A mixed-methods approach including pre-post study, matched case-control, and programmatic effects analysis.
• Comparison of emergency room visits, office visits, and hospital admissions between the treatment cohort and matched controls.
• Regression analysis to determine variables associated with changes in asthma severity.

Main Results:

• The treatment cohort experienced significantly fewer emergency room visits (7 vs. 28 per thousand) and more office visits (57 vs. 7 per thousand) compared to controls.
• No significant difference in hospital admission rates was observed between groups.
• Initial asthma severity and the frequency of patient-provider communications were key predictors of improved asthma outcomes.

Conclusions:

• The asthma disease management program effectively reduced acute healthcare utilization, supporting its design to improve care coordination.
• Increased patient engagement and communication appear closely linked to positive changes in asthma health status.
• The findings suggest that targeted communication strategies within disease management programs can enhance patient outcomes.