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Kaiser Permanente Study Shows HEDIS Asthma Measurements May Need Modification to Be More Accurate

Posted on: Thursday, 20 October 2005, 15:00 CDT

A Kaiser Permanente study indicates that Health Plan and Employer Data and Information Set (HEDIS) criteria have not accurately identified persistent asthma patients. Identifying patients who meet the HEDIS criteria for persistent asthma for two or more years is a better measure of persistent asthma and better reflects medication usage and emergency department and hospital utilization.

The study is published in the Oct. 16 American Journal of Managed Care and was supported by the Kaiser Permanente Health Care Program.

"A significant portion of patients had been misdiagnosed as having persistent asthma under HEDIS's previous one year entry criteria. Our study showed that three or more consecutive years of HEDIS qualification was much more accurate, but two years of qualification was a big improvement over one," said Eric Macy, M.D., of the Departments of Allergy, Kaiser Permanente San Diego Medical Center. "HEDIS has agreed to use two consecutive years of qualification as the case definition for persistent asthma starting in measurement year 2005 based on the data we presented to them."

The study was performed using information on 132,414 Kaiser Permanente health program patients nationwide who were included in one or more HEDIS persistent asthma study groups between 1999 and 2002. Medication, emergency room and hospitalization information for 2002 was gathered from electronic claims and pharmacy information.

Using the old HEDIS criteria, 47.9 percent of patients were identified as having persistent asthma during only one of four possible years; 40.8 percent of patients reported persistent asthma during at least two consecutive years; and 28.2 percent of the patients reported having persistent asthma for three or more consecutive years of evaluation.

Patients with more consecutive years of HEDIS persistent asthma qualification showed increased likelihood of frequent use of short-acting beta-agonists (aerosol inhaled by mouth to treat acute asthma attacks), inhaled anti-inflammatory corticosteroid use, at least one emergency department visit, and at least one hospitalization.

"A direct clinical validation study is probably needed to determine the best criteria for the most useful HEDIS persistent asthma case definition," said Macy.

In addition to Macy, the paper's other authors are: David Mosen, Ph.D., M.P.H., Kaiser Permanente Northwest Center for Health Research, Portland; Thomas Stibolt, M.D., Care Management Institute, Portland; Juli Goldstein, M.S., and Jim Bellows, Ph.D., of the Care Management Institute, Oakland; Michael Schatz, M.D., M.S., Department of Allergy, Kaiser Permanente San Diego Medical Center; Guillermo Mendoza, M.D., Vacaville, CA; and Jeryl McGaw, Ph.D., R.N., Kaiser Permanente Clinical Research Unit, Denver, Colo.

Kaiser Permanente is America's leading integrated health plan. Founded in 1945, it is a nonprofit, group practice prepayment program with Southern California headquarters in Pasadena, California. Kaiser Permanente serves the health care needs of 3.1 million members in Southern California. Today it encompasses the nonprofit Kaiser Foundation Health Plan, Inc., Kaiser Foundation Hospitals and their subsidiaries, and the for-profit Southern California Permanente Medical Group. Kaiser Permanente's Southern California Region includes more than 47,530 technical, administrative and clerical employees and caregivers, and more than 5,200 physicians representing all specialties.

www.kaiserpermanente.org

Source: Business Wire

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