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Development and Validation of the Asthma Exacerbation Risk Score Using Claims Data
Jonathan Hatoun1, Emily Trudell Correa2, Andrew J MacGinnitie3
1Pediatric Physicians' Organization at Children's (J Hatoun, ET Correa, and L Vernacchio), Wellesley, Mass; Division of General Pediatrics, Boston Children's Hospital (J Hatoun and L Vernacchio), Boston, Mass; Department of Pediatrics, Harvard Medical School (J Hatoun, AJ MacGinnitie, JM Gaffin, and L Vernacchio), Boston, Mass.
Academic Pediatrics
|July 13, 2021
Summary
Identifying high-risk pediatric asthma patients is crucial. The Asthma Exacerbation Risk (AER) score uses insurance claims to predict exacerbations, enabling targeted preventive care for children with asthma.
Area of Science:
- Pediatric pulmonology
- Health services research
- Biostatistics
Background:
- Pediatric asthma is a significant health burden, necessitating efficient identification of high-risk individuals for preventive interventions.
- Insurance claims data offer a comprehensive resource for analyzing healthcare utilization and predicting disease exacerbations.
Purpose of the Study:
- To develop and validate a predictive risk score for asthma exacerbations in pediatric patients.
- To utilize prior healthcare utilization patterns from insurance claims to forecast future exacerbation risk.
Main Methods:
- Retrospective analysis of insurance claims for 28,196 pediatric patients (ages 2-18) with continuous enrollment.
- Stepwise regression analysis to identify 10 key predictors of asthma exacerbation within a 12-month period.
- Development of the Asthma Exacerbation Risk (AER) score by weighting and summing identified predictors.
Main Results:
- Ten predictors were significantly associated with asthma exacerbations, including age, persistent asthma criteria, medication fill patterns, outpatient visit counts, recent exacerbations, and spirometry use.
- The AER score is calculated monthly from claims data.
- The AER score effectively identifies patients requiring interventions, such as asthma home-visiting programs.
Conclusions:
- The AER score provides a reliable method for predicting asthma exacerbation risk in children using readily available insurance claims data.
- This tool facilitates proactive patient management and resource allocation for preventive asthma care programs.
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