Flunking asthma? When HEDIS takes the ACT

Kaiser G. Lim, Ashok M. Patel, James M Naessens, James T. Li, Gerald W. Volcheck, Amy E. Wagie, Felicity T Enders, Timothy J. Beebe

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective: To test several patient-oriented asthma outcome measures and the Healthcare Effectiveness Data and Information Set (HEDIS) measure of appropriate medication for persistent asthma to determine the most useful quality indicator of asthma care. Design: Prospective mail survey of adult employees and dependents with asthma. Methods: The medical and pharmacy claims of all subjects from 12 months before and after the survey were abstracted. Outcomes measures included the Asthma Control Test (ACT), workday loss, unscheduled healthcare utilization (emergency department and inpatient care), and satisfaction with care. Results: Although 81% of all responders had well-controlled asthma, persistent asthma was uncontrolled in 28%. Only 64.5% received appropriate controller medication. Well-controlled asthma is associated with a high degree of satisfaction, less workday loss, fewer prednisone bursts, and minimal unscheduled healthcare utilization. Except for a reduced incidence of more than 2 oral corticosteroid dispensings (6.4% vs 13.6%, P = .012), compliance with the HEDIS appropriate medication for asthma was not positively associated with any of the patient-centered outcomes studied. Conclusions: Asthma control was the most useful patient outcome quality indicator in this study. Compliance with the HEDIS asthma measure in this population was not associated with a better patient-oriented outcome. This finding may be different with different levels of asthma control. The positive association between well-controlled asthma and patient satisfaction, minimal unscheduled healthcare utilization, and low workday loss suggests that asthma control as measured by ACT may be a better performance measure in asthma.

Original languageEnglish (US)
Pages (from-to)487-494
Number of pages8
JournalAmerican Journal of Managed Care
Volume14
Issue number8
StatePublished - Aug 2008

Fingerprint

Asthma
Delivery of Health Care
medication
utilization
mail survey
incidence
employee
Datasets
Outcome Assessment (Health Care)
performance
Postal Service
Prednisone
Patient Satisfaction
Hospital Emergency Service
Inpatients
Adrenal Cortex Hormones

ASJC Scopus subject areas

  • Medicine(all)
  • Nursing(all)
  • Health(social science)
  • Health Professions(all)

Cite this

Lim, K. G., Patel, A. M., Naessens, J. M., Li, J. T., Volcheck, G. W., Wagie, A. E., ... Beebe, T. J. (2008). Flunking asthma? When HEDIS takes the ACT. American Journal of Managed Care, 14(8), 487-494.

Flunking asthma? When HEDIS takes the ACT. / Lim, Kaiser G.; Patel, Ashok M.; Naessens, James M; Li, James T.; Volcheck, Gerald W.; Wagie, Amy E.; Enders, Felicity T; Beebe, Timothy J.

In: American Journal of Managed Care, Vol. 14, No. 8, 08.2008, p. 487-494.

Research output: Contribution to journalArticle

Lim, KG, Patel, AM, Naessens, JM, Li, JT, Volcheck, GW, Wagie, AE, Enders, FT & Beebe, TJ 2008, 'Flunking asthma? When HEDIS takes the ACT', American Journal of Managed Care, vol. 14, no. 8, pp. 487-494.
Lim KG, Patel AM, Naessens JM, Li JT, Volcheck GW, Wagie AE et al. Flunking asthma? When HEDIS takes the ACT. American Journal of Managed Care. 2008 Aug;14(8):487-494.
Lim, Kaiser G. ; Patel, Ashok M. ; Naessens, James M ; Li, James T. ; Volcheck, Gerald W. ; Wagie, Amy E. ; Enders, Felicity T ; Beebe, Timothy J. / Flunking asthma? When HEDIS takes the ACT. In: American Journal of Managed Care. 2008 ; Vol. 14, No. 8. pp. 487-494.
@article{1676f701211e47e6957ec458aa436c89,
title = "Flunking asthma? When HEDIS takes the ACT",
abstract = "Objective: To test several patient-oriented asthma outcome measures and the Healthcare Effectiveness Data and Information Set (HEDIS) measure of appropriate medication for persistent asthma to determine the most useful quality indicator of asthma care. Design: Prospective mail survey of adult employees and dependents with asthma. Methods: The medical and pharmacy claims of all subjects from 12 months before and after the survey were abstracted. Outcomes measures included the Asthma Control Test (ACT), workday loss, unscheduled healthcare utilization (emergency department and inpatient care), and satisfaction with care. Results: Although 81{\%} of all responders had well-controlled asthma, persistent asthma was uncontrolled in 28{\%}. Only 64.5{\%} received appropriate controller medication. Well-controlled asthma is associated with a high degree of satisfaction, less workday loss, fewer prednisone bursts, and minimal unscheduled healthcare utilization. Except for a reduced incidence of more than 2 oral corticosteroid dispensings (6.4{\%} vs 13.6{\%}, P = .012), compliance with the HEDIS appropriate medication for asthma was not positively associated with any of the patient-centered outcomes studied. Conclusions: Asthma control was the most useful patient outcome quality indicator in this study. Compliance with the HEDIS asthma measure in this population was not associated with a better patient-oriented outcome. This finding may be different with different levels of asthma control. The positive association between well-controlled asthma and patient satisfaction, minimal unscheduled healthcare utilization, and low workday loss suggests that asthma control as measured by ACT may be a better performance measure in asthma.",
author = "Lim, {Kaiser G.} and Patel, {Ashok M.} and Naessens, {James M} and Li, {James T.} and Volcheck, {Gerald W.} and Wagie, {Amy E.} and Enders, {Felicity T} and Beebe, {Timothy J.}",
year = "2008",
month = "8",
language = "English (US)",
volume = "14",
pages = "487--494",
journal = "American Journal of Managed Care",
issn = "1088-0224",
publisher = "Ascend Media",
number = "8",

}

TY - JOUR

T1 - Flunking asthma? When HEDIS takes the ACT

AU - Lim, Kaiser G.

AU - Patel, Ashok M.

AU - Naessens, James M

AU - Li, James T.

AU - Volcheck, Gerald W.

AU - Wagie, Amy E.

AU - Enders, Felicity T

AU - Beebe, Timothy J.

PY - 2008/8

Y1 - 2008/8

N2 - Objective: To test several patient-oriented asthma outcome measures and the Healthcare Effectiveness Data and Information Set (HEDIS) measure of appropriate medication for persistent asthma to determine the most useful quality indicator of asthma care. Design: Prospective mail survey of adult employees and dependents with asthma. Methods: The medical and pharmacy claims of all subjects from 12 months before and after the survey were abstracted. Outcomes measures included the Asthma Control Test (ACT), workday loss, unscheduled healthcare utilization (emergency department and inpatient care), and satisfaction with care. Results: Although 81% of all responders had well-controlled asthma, persistent asthma was uncontrolled in 28%. Only 64.5% received appropriate controller medication. Well-controlled asthma is associated with a high degree of satisfaction, less workday loss, fewer prednisone bursts, and minimal unscheduled healthcare utilization. Except for a reduced incidence of more than 2 oral corticosteroid dispensings (6.4% vs 13.6%, P = .012), compliance with the HEDIS appropriate medication for asthma was not positively associated with any of the patient-centered outcomes studied. Conclusions: Asthma control was the most useful patient outcome quality indicator in this study. Compliance with the HEDIS asthma measure in this population was not associated with a better patient-oriented outcome. This finding may be different with different levels of asthma control. The positive association between well-controlled asthma and patient satisfaction, minimal unscheduled healthcare utilization, and low workday loss suggests that asthma control as measured by ACT may be a better performance measure in asthma.

AB - Objective: To test several patient-oriented asthma outcome measures and the Healthcare Effectiveness Data and Information Set (HEDIS) measure of appropriate medication for persistent asthma to determine the most useful quality indicator of asthma care. Design: Prospective mail survey of adult employees and dependents with asthma. Methods: The medical and pharmacy claims of all subjects from 12 months before and after the survey were abstracted. Outcomes measures included the Asthma Control Test (ACT), workday loss, unscheduled healthcare utilization (emergency department and inpatient care), and satisfaction with care. Results: Although 81% of all responders had well-controlled asthma, persistent asthma was uncontrolled in 28%. Only 64.5% received appropriate controller medication. Well-controlled asthma is associated with a high degree of satisfaction, less workday loss, fewer prednisone bursts, and minimal unscheduled healthcare utilization. Except for a reduced incidence of more than 2 oral corticosteroid dispensings (6.4% vs 13.6%, P = .012), compliance with the HEDIS appropriate medication for asthma was not positively associated with any of the patient-centered outcomes studied. Conclusions: Asthma control was the most useful patient outcome quality indicator in this study. Compliance with the HEDIS asthma measure in this population was not associated with a better patient-oriented outcome. This finding may be different with different levels of asthma control. The positive association between well-controlled asthma and patient satisfaction, minimal unscheduled healthcare utilization, and low workday loss suggests that asthma control as measured by ACT may be a better performance measure in asthma.

UR - http://www.scopus.com/inward/record.url?scp=49549116205&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=49549116205&partnerID=8YFLogxK

M3 - Article

C2 - 18690764

AN - SCOPUS:49549116205

VL - 14

SP - 487

EP - 494

JO - American Journal of Managed Care

JF - American Journal of Managed Care

SN - 1088-0224

IS - 8

ER -