The utility of the Health Plan Employer Data and Information Set (HEDIS) asthma measure to predict asthma-related outcomes.
BACKGROUND
The Health Plan Employer Data and Information Set (HEDIS) measures are used extensively to measure quality of care.


OBJECTIVE
To evaluate selected aspects of the HEDIS measure of appropriate use of asthma medications.


METHODS
Claims data were analyzed for commercial health plan members who met HEDIS criteria for persistent asthma in 1999. The use of asthma medications was evaluated in the subsequent year with stratification by controller medication and a measure of adherence (days' supply). Multivariate logistic regressions were used to evaluate the association among long-term controller therapy for persistent asthma, adherence to therapy, and asthma-related hospitalizations or emergency department (ED) visits, controlling for demographic, preindex utilization, and other confounding characteristics.


RESULTS
Of the 49,637 persistent asthma patients, approximately 35.7% were using 1 class of long-term controller medications, 18.4% were using more than 1 class, and 45.9% were not using such medication. More than 25% of the persistent asthma patients did not use any asthma medication in the subsequent year. Patients with low adherence to controller medication had a significantly higher risk (odds ratio [OR], 1.72; 95% confidence interval [CI], 1.42-2.08) of ED visit or hospitalization relative to patients not using any controllers compared with persons with moderate (OR, 0.84; 95% CI, 0.57-1.23) or high (OR, 0.70; 95% CI, 0.34-1.44) adherence. Patients receiving a high days' supply of inhaled corticosteroids had the lowest risk of ED visit or hospitalization (OR, 0.37; 95% CI, 0.05-2.69).


CONCLUSIONS
Our findings suggest that refinements to the HEDIS measure method for identifying patients with persistent asthma may be needed.
Berger
William E
WE
American College of Allergy, Asthma, and Immunology, Mission Viejo, California, USA.
Legorreta
Antonio P
AP
Blaiss
Michael S
MS
Schneider
Eric C
EC
Luskin
Allan T
AT
Stempel
David A
DA
Suissa
Samy
S
Goodman
David C
DC
Stoloff
Stuart W
SW
Chapman
Jean A
JA
Sullivan
Sean D
SD
Vollmer
Bill
B
Weiss
Kevin B
KB
D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000145:classification / Q000188:drug therapy*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010349:Patient Compliance
D018927:Anti-Asthmatic Agents