Validity of the HEDIS criteria to identify children with persistent asthma and sustained high utilization

Anne L. Fuhlbrigge, Vincent J. Carey, Jonathan A. Finkelstein, Paula Lozano, Thomas Inui, Scott T. Weiss, Kevin B. Weiss

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: The most widely used performance measure for asthma, the Health Plan Employer Data and Information Set (HEDIS), has been criticized because the delay between classification (year 1) and assessment of medication dispensing (year 2) may produce a "misalignment" and weaken the validity of the measure. Objective: To examine whether a previously observed association between the HEDIS performance measure and asthma-related emergency department visits is robust when the period between the classification and outcome assessment is evaluated during a 2-year period as defined. Methods: Children (N = 2766) aged 3 to 15 years enrolled in 1 of 3 managed care organizations with at least 1 asthma diagnosis listed for a hospitalization, an emergency department visit, or an ambulatory encounter and at least 2 consecutive years of data for analysis from July 1996 through June 1999 were identified. Results: Children did not consistently meet the HEDIS criteria for persistent asthma, and 24% to 28% of children did not requalify in year 2 of observation. Multivariate regression models showed that a protective relationship between controller medication dispensing and asthma-related emergency department visits was no longer seen among children meeting the HEDIS criteria for persistent asthma when the total period of observation is extended to 2 years (odds ratio, 0.7; 95% confidence interval, 0.4-1.2). Conclusions: Our results suggest that the variable nature of asthma may affect how the HEDIS performance measure should be used for assessing quality of care. The period between identification of the target population and performance assessment should be closely related in time.

Original languageEnglish
Pages (from-to)325-330
Number of pages6
JournalAmerican Journal of Managed Care
Volume11
Issue number5
StatePublished - May 2005

Fingerprint

employer
Asthma
utilization
Health
health
Hospital Emergency Service
medication
performance
Observation
performance assessment
Quality of Health Care
hospitalization
Health Services Needs and Demand
managed care
Managed Care Programs
Datasets
confidence
Hospitalization
Odds Ratio
regression

ASJC Scopus subject areas

  • Nursing(all)
  • Medicine(all)
  • Health(social science)
  • Health Professions(all)

Cite this

Fuhlbrigge, A. L., Carey, V. J., Finkelstein, J. A., Lozano, P., Inui, T., Weiss, S. T., & Weiss, K. B. (2005). Validity of the HEDIS criteria to identify children with persistent asthma and sustained high utilization. American Journal of Managed Care, 11(5), 325-330.

Validity of the HEDIS criteria to identify children with persistent asthma and sustained high utilization. / Fuhlbrigge, Anne L.; Carey, Vincent J.; Finkelstein, Jonathan A.; Lozano, Paula; Inui, Thomas; Weiss, Scott T.; Weiss, Kevin B.

In: American Journal of Managed Care, Vol. 11, No. 5, 05.2005, p. 325-330.

Research output: Contribution to journalArticle

Fuhlbrigge, AL, Carey, VJ, Finkelstein, JA, Lozano, P, Inui, T, Weiss, ST & Weiss, KB 2005, 'Validity of the HEDIS criteria to identify children with persistent asthma and sustained high utilization', American Journal of Managed Care, vol. 11, no. 5, pp. 325-330.
Fuhlbrigge, Anne L. ; Carey, Vincent J. ; Finkelstein, Jonathan A. ; Lozano, Paula ; Inui, Thomas ; Weiss, Scott T. ; Weiss, Kevin B. / Validity of the HEDIS criteria to identify children with persistent asthma and sustained high utilization. In: American Journal of Managed Care. 2005 ; Vol. 11, No. 5. pp. 325-330.
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