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The European Journal of Health Economics
Published in: The European Journal of Health Economics 2/2017

Open Access 01-03-2017 | Original Paper

Assessing asthma severity based on claims data: a systematic review

Authors: Christian Jacob, Jennifer S. Haas, Benno Bechtel, Peter Kardos, Sebastian Braun

Published in: The European Journal of Health Economics | Issue 2/2017

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Abstract

Introduction

Asthma is one of the most common chronic diseases in Germany. Substantial economic evaluation of asthma cost requires knowledge of asthma severity, which is in general not part of claims data. Algorithms need to be defined to use this data source.

Aims and objectives

The aim of this study was to systematically review the international literature to identify algorithms for the stratification of asthma patients according to disease severity based on available information in claims data.

Methods

A systematic literature review was conducted in September 2015 using the DIMDI SmartSearch, a meta search engine including several databases with a national and international scope, e.g. BIOSIS, MEDLINE, and EMBASE. Claims data based studies that categorize asthma patients according to their disease severity were identified.

Results

The systematic research yielded 54 publications assessing asthma severity based on claims data. Thirty-nine studies used a standardized algorithm such as HEDIS, Leidy, the GINA based approach or CACQ. Sixteen publications applied a variety of different criteria for the severity categorisation such as asthma diagnoses, asthma-related drug prescriptions, emergency department visits, and hospitalisations.

Conclusion

There is no best practice method for the categorisation of asthma severity with claims data. Rather, a combination of algorithms seems to be a pragmatic approach. A transfer to the German context is not entirely possible without considering particular conditions associated with German claims data.
Literature
1.
Buhl, R., Berdel, D., Criée, C.-P.: Leitlinie zur Diagnostik und Therapie von Patienten mit Asthma. Pneumologie 60, 139–183 (2006)CrossRefPubMed
2.
3.
4.
Taylor, D.R., Bateman, E.D., Boulet, L.-P., Boushey, H.A., Busse, W.W., Casale, T.B., Chanez, P., Enright, P.L., Gibson, P.G., de Jongste, J.C., Kerstjens, H.A., Lazarus, S.C., Levy, M.L., O'Byrne, P.M., Partridge, M.R., Pavord, I.D., Sears, M.R., Sterk, P.J., Stoloff, S.W., Szefler, S.J., Sullivan, S.D., Thomas, M.D., Wenzel, S.E., Reddel, H.K.: A new perspective on concepts of asthma severity and control. Eur. Respir. J. 32(3), 545–554 (2008)CrossRefPubMed
5.
Global Initiative for Asthma. Asthma Management and Prevention. National Institutes of Health, Bethesda, NIH Publication number 95-3659A (1995)
6.
Birnbaum, H.G., Ivanova, J.I., Yu, A.P., Hsieh, M., Seal, B., Emani, S., Rosiello, R., Colice, G.L.: Asthma severity categorization using a claims-based algorithm or pulmonary function testing. J. Asthma 46(1), 67–72 (2009)CrossRefPubMed
7.
Zeidler, J., Braun, S.: Sekundärdatenanalysen. In: Schöffski, O., Graf von der Schulenburg, J.-M. (eds.) Gesundheitsökonomische Evaluationen, 4th edn. Springer, Heidelberg (2012)
8.
Schatz, M., Zeiger, R.S., Yang, S.J., Chen, W., Crawford, W.W., Sajjan, S.G., Allen-Ramey, F.: Persistent asthma defined using HEDIS versus survey criteria. Am. J. Manag. Care 16(11), 281–288 (2010)
9.
Broder, M.S., Gutierrez, B., Chang, E., Meddis, D., Schatz, M.: Ratio of controller to total asthma medications: determinants of the measure. Am. J. Manag. Care 16(3), 170–178 (2010)PubMed
10.
Colice, G.L., Yu, A.P., Ivanova, J.I., Hsieh, M., Birnbaum, H.G., Lage, M.J., Brewster, C.: Costs and resource use of mild persistent asthma patients initiated on controller therapy. J. Asthma 45(4), 293–299 (2008)CrossRefPubMed
11.
Schatz, M., Zeiger, R.S.: Improving asthma outcomes in large populations. J. Allergy Clin. Immunol. 128(2), 273–277 (2011)CrossRefPubMed
12.
Yong, P.L., Werner, R.M.: Process quality measures and asthma exacerbations in the medicaid population. J. Allergy Clin. Immunol. 124(5), 961–966 (2009)CrossRefPubMed
13.
Yoon, A.C., Crawford, W., Sheikh, J., Nakahiro, R., Gong, A., Schatz, M.: The hedis medication management for people with asthma measure does not correlate with improved asthma outcomes. J. Allergy Clin. Immunol. Pract. 3, 547–552 (2015)CrossRef
14.
Dombkowski, K.J., Cabana, M.D., Cohn, L.M., Gebremariam, A., Clark, S.J.: Geographic variation of asthma quality measures within and between health plans. Am. J. Manag. Care 11(12), 765–772 (2005)PubMed
15.
Vernacchio, L., Trudell, E.K., Muto, J.M.: Correlation of care process measures with childhood asthma exacerbations. Pediatrics 131(1), 136–143 (2013)CrossRef
16.
Zeiger, R.S., Schatz, M., Li, Q., Solari, P.G., Zazzali, J.L., Chen, W.: Real-time asthma outreach reduces excessive short-acting beta2-agonist use: a randomized study. J. Allergy Clin. Immunol. Pract. 2(4), 445–456 (2014)CrossRefPubMed
17.
Schatz, M., Zeiger, R.S., Yang, S.J., Chen, W., Crawford, W.W., Sajjan, S.G., Allen-Ramey, F.: Relationship of asthma control to asthma exacerbations using surrogate markers within a managed care database. Am. J. Manag. Care 16(5), 327–333 (2010)PubMed
18.
Berger, W.E., Legorreta, A.P., Blaiss, M.S., Schneider, E.C., Luskin, A.T., Stempel, D.A., Suissa, S., Goodman, D.C., Stoloff, S.W., Chapman, J.A., Sullivan, S.D., Vollmer, B., Weiss, K.B.: The utility of the Health Plan Employer Data and Information Set (HEDIS) asthma measure to predict asthma-related outcomes. Ann. Allergy Asthma Immunol. 93, 538–545 (2004)CrossRefPubMed
19.
Leidy, N.K., Paramore, L.C., Watrous, M.L., Doyle, J., Zeiger, R.S.: Development of an algorithm for estimating asthma severity from an administrative cost database. Value in Health 2, 394 (1999)CrossRef
20.
21.
Firoozi, F., Lemière, C., Beauchesne, M.F., Forget, A., Blais, L.: Development and validation of database indexes of asthma severity and control. Thorax 62(7), 581–587 (2007)CrossRefPubMedPubMedCentral
22.
Andrews, A.L., Teufel, R.J., Basco, W.T.: Low rates of controller medication initiation and outpatient follow-up after emergency department visits for asthma. J. Pediatr. 160(2), 325–330 (2012)CrossRefPubMed
23.
Baxter, J.D., Samnaliev, M., Clark, R.E.: The quality of asthma care among adults with substance-related disorders and adults with mental illness. Psychiatr. Serv. (Washington, D.C.) 60(1), 43–49 (2009)CrossRef
24.
Cabana, M., Slish, K.K., Nan, B., Leo, H., Bratton, S.L., Dombkowski, K.J.: Outcomes associated with spirometry for pediatric asthma in a managed care organization. Pediatrics 118(1), 151–156 (2006)CrossRef
25.
Canino, G., Vila, D., Normand, S.L., Acosta-Pérez, E., Ramírez, R., García, P., Rand, C.: Reducing asthma health disparities in poor Puerto Rican children: the effectiveness of a culturally tailored family intervention. J. Allergy Clin. Immunol. 121(3), 665–670 (2008)CrossRefPubMed
26.
Dombkowski, K.J., Wasilevich, E.A., Lyon-Callo, S.K.: Pediatric asthma surveillance using medicaid claims. Public Health Rep. (Washington, D.C.: 1974) 120(5), 515–524 (2005)CrossRef
27.
Finkelstein, J.A., Lozano, P., Fuhlbrigge, A.L., Carey, V.J., Inui, T.S., Soumerai, S.B., Sullivan, S.D., Wagner, E.H., Weiss, S.T., Weiss, K.B., Pediatric Asthma Care Patient Outcomes Research Team 2005: Practice-level effects of interventions to improve asthma care in primary care settings: the Pediatric Asthma Care Patient Outcomes Research Team. Health Serv. Res. 40(6 Pt 1), 1737–1757 (2005)CrossRefPubMedPubMedCentral
28.
Fuhlbrigge, A., Carey, V.J., Finkelstein, J.A., Lozano, P., Inui, T.S., Weiss, K.B.: Are performance measures based on automated medical records valid for physician/practice profiling of asthma care? Med. Care 46(6), 620–626 (2008)CrossRefPubMed
29.
Hsu, R.T., Crawford, W.W., Klaustermeyer, W.B.: Emergency department utilization by patients not meeting Health Plan and Employer Data and Information Set (HEDIS) criteria for persistent asthma. Allergy Asthma Proc 29(1), 62–66 (2008)CrossRefPubMed
30.
Mosen, D.M., Schatz, M., Gold, R., Mularski, R.A., Wong, W.F., Bellows, J.: Medication use, emergency hospital care utilization, and quality-of-life outcome disparities by race/ethnicity among adults with asthma. Am. J. Manag. Care 16(11), 821–828 (2010)PubMed
31.
Richardson, L.P., Lozano, P., Russo, J., McCauley, E., Bush, T., Katon, W.: Asthma symptom burden: relationship to asthma severity and anxiety and depression symptoms. Pediatrics 118(3), 1042–1051 (2006)CrossRefPubMed
32.
Schatz, M., Zeiger, R.S., Mosen, D., Apter, A.J., Vollmer, W.M., Stibolt, T.B., Leong, A., Johnson, M.S., Mendoza, G., Cook, E.F.: Improved asthma outcomes from allergy specialist care: a population-based cross-sectional analysis. J. Allergy Clin. Immunol. 116(6), 1307–1313 (2005)CrossRefPubMed
33.
Schatz, M., Nakahiro, R., Crawford, W., Mendoza, G., Mosen, D., Stibolt, T.B.: Asthma quality-of-care markers using administrative data. Chest 128(4), 1968–1973 (2005)CrossRefPubMed
34.
Schatz, M., Zeiger, R.S., Vollmer, W.M., Mosen, D., Apter, A.J., Stibolt, T.B., Leong, A., Johnson, M.S., Mendoza, G., Cook, E.F.: Validation of a beta-agonist long-term asthma control scale derived from computerized pharmacy data. J. Allergy Clin. Immunol. 117(5), 995–1000 (2006)CrossRefPubMed
35.
Wakefield, D.B., Cloutier, M.M.: Modifications to HEDIS and CSTE algorithms improve case recognition of pediatric asthma. Pediatr. Pulmonol. 41(10), 962–971 (2006)CrossRefPubMed
36.
Wilson, S.E., Leonard, A., Moomaw, C., Schneeweiss, S., Eckman, M.H.: Underuse of controller medications among children with persistent asthma in the Ohio medicaid population: evolving differences with new medications. Ambul. Pediatr. 5(2), 83–89 (2005)CrossRefPubMed
37.
Colice, G., Wu, E.Q., Birnbaum, H., Daher, M., Marynchenko, M.B., Varghese, S.: Healthcare and workloss costs associated with patients with persistent asthma in a privately insured population. J. Occup. Environ. Med. 48(8), 794–802 (2006)CrossRefPubMed
38.
Colice, G., Wu, E.Q., Birnbaum, H., Daher, M., Maryna, B.M.: Use of inhaled corticosteroids and healthcare costs in mild persistent asthma. J. Asthma 44(6), 479–483 (2007)CrossRefPubMed
39.
Ivanova, J.I., Birnbaum, H.G., Hsieh, M., Yu, A.P., Seal, B., van der Molen, T., Emani, S., Rosiello, R.A., Colice, G.L.: Adherence to inhaled corticosteroid use and local adverse events in persistent asthma. Am. J. Manag. Care 14(12), 801–809 (2008)PubMed
40.
Ivanova, J.I., Bergman, R., Birnbaum, H.G., Colice, G.L., Silverman, R.A., McLaurin, K.: Effect of asthma exacerbations on health care costs among asthmatic patients with moderate and severe persistent asthma. J. Allergy Clin. Immunol. 129(5), 1229–1235 (2012)CrossRefPubMed
41.
Schatz, M., Zeiger, R.S., Yang, S.J., Chen, W., Kosinski, M.: Further validation and definition of the psychometric properties of the Asthma Impact Survey. J. Allergy Clin. Immunol. 128(1), 44–49 (2011)CrossRefPubMed
42.
Allen-Ramey, F.C., Bukstein, B., Luskin, A., Sajjan, S.G., Markson, L.E.: Administrative claims analysis of asthma-related health care utilization for patients who received inhaled corticosteroids with either montelukast or salmeterol as combination therapy. J. Manag. Care Pharm. 12(4), 310–321 (2006)PubMed
43.
Erickson, S.R., Kirking, D.M.: Variation in the distribution of patient-reported outcomes based on different definitions of defining asthma severity. Curr. Med. Res. Opin. 20(12), 1863–1872 (2004)CrossRefPubMed
44.
Wells, K.E., Peterson, E.L., Ahmedani, B.K., Williams, L.K.: Real-world effects of once vs greater daily inhaled corticosteroid dosing on medication adherence. Ann. Allergy Asthma Immunol. 111(3), 216–220 (2013)CrossRefPubMedPubMedCentral
45.
Blais, L., Beauchesne, M.F.: Use of inhaled corticosteroids following discharge from an emergency department for an acute exacerbation of asthma. Thorax 59(943), 947 (2004)
46.
Blais, L., Kettani, F.Z., Forget, A.: Relationship between maternal asthma, its severity and control and abortion. Hum. Reprod. 28(4), 908–915 (2013)CrossRefPubMed
47.
Blais, L., Kettani, F.Z., Forget, A.: Associations of maternal asthma severity and control with pregnancy complications. J. Asthma 51(4), 391–398 (2014)CrossRefPubMed
48.
Firoozi, F., Lemière, C., Ducharme, F.M., Beauchesne, M.F., Perreault, S., Bérard, A., Ferreira, E., Forget, A., Blais, L.: Effect of maternal moderate to severe asthma on perinatal outcomes. Respir. Med. 104(9), 1278–1287 (2010)CrossRefPubMed
49.
Friedman, H.S., Navaratnam, P., McLaughlin, J.: Adherence and asthma control with mometasone furoate versus fluticasone propionate in adolescents and young adults with mild asthma. J. Asthma 47(9), 994–1000 (2010)CrossRefPubMed
50.
Friedman, H.S., Urdaneta, E., McLaughlin, J.M., Navaratnam, P.: Mometasone furoate versus beclomethasone dipropionate: effectiveness in patients with mild asthma. Am. J. Manag. Care 16(7), e151–e156 (2010)PubMed
51.
Friedman, H.S., Yawn, B.P.: Resource utilization in asthma: combined fluticasone propionate/salmeterol compared with inhaled corticosteroids. Curr. Med. Res. Opin. 23(2), 427–434 (2007)CrossRefPubMed
52.
Navaratnam, P.: Incidence of exacerbations and hospitalizations is reduced and time to exacerbations is prolonged with mometasone furoate dry powder inhaler versus beclomethasone dipropionate hydrofluoroalkane aerosol in patients with mild asthma. Health Outcomes Res. Med. 1(2), 93–102 (2010)CrossRef
53.
Navaratnam, P., Friedman, H.S., Urdaneta, E.: The impact of adherence and disease control on resource use and charges in patients with mild asthma managed on inhaled corticosteroid agents. Patient Prefer. Adher. 4, 197–205 (2010)
54.
Navaratnam, P., Friedman, H.S., Urdaneta, E.: Mometasone furoate vs fluticasone propionate with salmeterol: multivariate analysis of resource use and asthma-related charges. Curr. Med. Res. Opin. 25(12), 2895–2901 (2009)CrossRefPubMed
55.
Friedman, H., Wilcox, T., Reardon, G., Crespi, S., Yawn, B.P.: A retrospective study of the use of fluticasone propionate/salmeterol combination as initial asthma controller therapy in a commercially insured population. Clin. Ther. 30(10), 1908–1917 (2008)CrossRefPubMed
56.
Gillies, T.D., Tomlin, A.M., Dovey, S.M., Tilyard, M.W.: Ethnic disparities in asthma treatment and outcomes in children aged under 15 years in New Zealand: analysis of national databases. Primary Care Respir. J. 22(3), 312–318 (2013)CrossRef
57.
Guo, J., Tsai, K., Kelton, C., Bian, B., Wigle, P.: Risk of serious asthma exacerbations associated with long-acting-beta-agonists among medicaid patients with asthma: a retrospective cohort study. Ann. Allergy Asthma Immunol. 106(3), 214–222 (2011)CrossRefPubMed
58.
Jacob C., Bechtel, B., Engel, S., Kardos, P., Linder, R., Braun, S., Greiner, W.: Healthcare costs and resource utilization of asthma in Germany: a claims data analysis. Eur. J. Health Econ. (2015) doi:10.​1007/​s10198-015-0671-3
59.
Rust, G., Zhang, S., Reynolds, J.: Inhaled corticosteroid adherence and emergency department utilization among Medicaid-enrolled children with asthma. J. Asthma 50(7), 769–775 (2013)CrossRefPubMedPubMedCentral
60.
Vaidya, V., Gupte, R., Balkrishnan, R.: Failure to refill essential prescription medications for asthma among pediatric Medicaid beneficiaries with persistent asthma. Patient Prefer. Adher. 7, 21–26 (2013)CrossRef
61.
Wertz, D.A., Pollack, M., Rodgers, K., Bohn, R.L., Sacco, P., Sullivan, S.D.: Impact of asthma control on sleep, attendance at work, normal activities, and disease burden. Ann. Allergy Asthma Immunol 105(2), 118–123 (2010)CrossRefPubMed
62.
Klemets, P., Lyytikäinen, O., Ruutu, P., Ollgren, J., Kaijalainen, T., Leinonen, M., Nuorti, J.P.: Risk of invasive pneumococcal infections among working age adults with asthma. Thorax 65, 698–702 (2010)CrossRefPubMed
63.
Talbot, T.R., Hartert, T.V., Mitchel, E., Halasa, N.B., Arbogast, P.G., Poehling, K.A., Schaffner, W., Craig, A.S., Griffin, M.R.: Asthma as a risk factor for invasive pneumococcal disease. N Engl J Med 352, 2082–2090 (2005)CrossRefPubMed
64.
Cai, B., Blais, L., Suissa, S., et al.: Distribution of asthma severity and change in severity over time in a general population [abstract]. In: American Lung Association/American Thoracic Society International Conference, San Diego, CA (1999)
65.
De Smet, B.D., Erickson, S.R., Kirking, D.M.: Self-reported adherence in patients with asthma. Ann. Pharmacother. 40(3), 414–420 (2006)CrossRefPubMed
66.
Thomas, M., Cleland, J., Price, D.: Database studies in asthma pharmacoeconomics. Expert Opin. Pharmacother. 4(3), 351–358 (2003)CrossRefPubMed
67.
Cabana, M.D., Slish, K.K., Nan, B., Clark, N.M.: Limits of the HEDIS criteria in determining asthma severity for children. Pediatrics 114(4), 1049–1055 (2004)CrossRefPubMed
Metadata
Title
Assessing asthma severity based on claims data: a systematic review
Authors
Christian Jacob
Jennifer S. Haas
Benno Bechtel
Peter Kardos
Sebastian Braun
Publication date
01-03-2017
Publisher
Springer Berlin Heidelberg
Published in
The European Journal of Health Economics / Issue 2/2017
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-016-0769-2

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