Comparative evaluation of two asthma care quality measures among Medicaid beneficiaries.
BACKGROUND
The relative performance of asthma care quality measures has not been evaluated in Medicaid populations.


METHODS
Using complete claims and pharmaceutical data for 19,076 patients with persistent asthma (based on Health Effectiveness and Data Information Set criteria) in five Medicaid populations, we compared the following two measures of asthma care quality: filling prescriptions for controller asthma medications within 1 year and the ratio of controller medication to the total number of asthma medication prescriptions filled within 1 year. We calculated whether meeting each quality measure was associated with decreased odds of emergency department (ED) treatment episodes. We then compared the odds ratios, receiver operating characteristic (ROC) curves, and deviances between models, using each measure to predict ED utilization in Medicaid populations.


RESULTS
Although meeting each measure was associated with lower odds of ED utilization, this decrease was larger if the controller asthma medication measure was met rather than the ratio measure. Additionally, models using the controller medication measure had greater areas under the ROC curve and smaller deviances than models using the ratio measure.


CONCLUSIONS
Both administrative measures of asthma care quality were associated with lower odds of ED utilization. The controller medication measure of asthma care quality may be better than the ratio measure in relation to emergency asthma care utilization by Medicaid beneficiaries.
Samnaliev
Mihail
M
Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA. Electronic address: mihail.samnaliev@umassmed.edu.
Baxter
Jeffrey D
JD
Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA.
Clark
Robin E
RE
Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA.
D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000628:therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D008875:Middle Aged; D016017:Odds Ratio; D019984:Quality Indicators, Health Care; D012372:ROC Curve; D014481:United States; D055815:Young Adult
D001993:Bronchodilator Agents