TY - JOUR
T1 - Association of asthma control with health care utilization
T2 - A prospective evaluation
AU - Vollmer, William M.
AU - Markson, Leona E.
AU - O'Connor, Elizabeth
AU - Frazier, E. Ann
AU - Berger, Marc
AU - Buist, A. Sonia
PY - 2002/1/15
Y1 - 2002/1/15
N2 - Population-based disease management should be enhanced by good risk assessment models and instruments. We prospectively evaluated the ability of a simple measure of short-term asthma control (scored 0 to 4) to predict asthma 12-mo health care utilization (HCU). A total of 5,172 adult asthma patients completed a brief questionnaire in fall 1997 to assess current level of asthma control. We then evaluated HCU for calendar year 1998. Ninety-three percent had health plan eligibility in 1998 and were included in this analysis. Both acute and routine asthma utilization increased with increasing numbers of asthma control problems. Rates of acute care episodes were 3.5 (95% confidence interval [Cl] = 2.9, 4.3) times more likely for those with 3 to 4 control problems versus those with no control problems. Lesser, but statistically significant, increases were seen for those with two (relative risk [RR] = 1.7, 95% Cl = 1.4, 2.2) or one (RR = 1.4, 95% Cl = 1.1, 1.8) control problems. These patterns were similar for men and women, and diminished with increasing age. The asthma control index contributed significantly to prospective prediction models even after adjusting for administrative data such as medication use and prior HCU. These data reinforce the usefulness of measures of short-term asthma control both for the individual clinician and for those interested in population-based asthma management.
AB - Population-based disease management should be enhanced by good risk assessment models and instruments. We prospectively evaluated the ability of a simple measure of short-term asthma control (scored 0 to 4) to predict asthma 12-mo health care utilization (HCU). A total of 5,172 adult asthma patients completed a brief questionnaire in fall 1997 to assess current level of asthma control. We then evaluated HCU for calendar year 1998. Ninety-three percent had health plan eligibility in 1998 and were included in this analysis. Both acute and routine asthma utilization increased with increasing numbers of asthma control problems. Rates of acute care episodes were 3.5 (95% confidence interval [Cl] = 2.9, 4.3) times more likely for those with 3 to 4 control problems versus those with no control problems. Lesser, but statistically significant, increases were seen for those with two (relative risk [RR] = 1.7, 95% Cl = 1.4, 2.2) or one (RR = 1.4, 95% Cl = 1.1, 1.8) control problems. These patterns were similar for men and women, and diminished with increasing age. The asthma control index contributed significantly to prospective prediction models even after adjusting for administrative data such as medication use and prior HCU. These data reinforce the usefulness of measures of short-term asthma control both for the individual clinician and for those interested in population-based asthma management.
KW - Asthma
KW - Asthma disease management
KW - Health care utilization
KW - Level of control
KW - Severity
UR - http://www.scopus.com/inward/record.url?scp=0037080921&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0037080921&partnerID=8YFLogxK
U2 - 10.1164/ajrccm.165.2.2102127
DO - 10.1164/ajrccm.165.2.2102127
M3 - Article
C2 - 11790654
AN - SCOPUS:0037080921
SN - 1073-449X
VL - 165
SP - 195
EP - 199
JO - American journal of respiratory and critical care medicine
JF - American journal of respiratory and critical care medicine
IS - 2
ER -