Campbell D, Wu A, Yasui Y, Skinner A, Steinwachs D.

AHSR FHSR Annu Meet Abstr Book. 1995; 12: 84-5.

Department of Health Policy and Management, 624 North Broadway, Room 612, Baltimore, MD 21205, USA.

PROBLEMS AND OBJECTIVES. Measurement of asthma severity is central to assuring fair, severity-adjusted, quality of asthma care comparisons among managed care organizations (MCOs). This paper describes development and validation of an asthma severity measure from patient self-reported symptoms for the Managed Health Care Association's (MHCA) Outcome Management System (OMS) Asthma project's risk adjusted comparisons of asthma care performance among 16 MCOs. DATA AND METHODS. Data from 3,750 respondents to a 1994 baseline survey of asthma patients enrolled in 16 MCOs nationwide was used to develop and test concurrent validity of the asthma severity measure. "Mild," "moderate" or "severe" classification was based on national and international guideline criteria and included the following elements; frequency of symptoms (wheezing, chest tightness, shortness of breath), nocturnal awakenings and chronicity of symptoms. Concurrent validity was assessed by correlations between asthma severity and criterion measures and by statistical tests for significant differences in means and proportions of criterion measures across severity levels. RESULTS AND CONCLUSIONS. Concurrent criterion validity is supported by modest correlations with criterion measures and statistically significant differences in means and proportions across asthma severity levels for criterion measures as hypothesized; general health status was lower and asthma-related disability, use of medications and use of health services were higher as severity increased. For example, proportions of severe, moderate and mild asthmatics with corticosteroid inhalers were 74%, 65% and 50% respectively. Proportions of severe, moderate and mild asthmatics who canceled usual activities due to asthma were 32%, 8% and 0.5% respectively. IMPLICATIONS FOR AUDIENCE. A valid asthma severity risk adjuster for quality of care comparisons among MCOs can be developed from patient-reported symptoms.

Publication Types:

• Meeting Abstracts

Keywords:

• Adrenal Cortex Hormones
• Asthma
• Humans
• Managed Care Programs
• Research Design
• Risk Adjustment
• Weights and Measures
• economics
• hsrmtgs

Other ID:

• HTX/96648552

UI: 102215570

From Meeting Abstracts