Department of Allergy, Kaiser Permanente Medical Center, 7060 Clairemont Mesa Blvd, San Diego, CA 92111, USA.
Am J Manag Care. 2010 Nov 1;16(11):e281-8.
To describe the relationships between persistent asthma defined by administrative versus survey data and their stability over time.
Longitudinal survey and retrospective administrative database.
Administrative data were used to identify patients meeting the Healthcare Effectiveness Data and Information Set (HEDIS) criteria for persistent asthma in year 1 (2006). At the end of year 2 and on 3 occasions during year 3, patients were mailed a survey to define persistent asthma based on symptoms and medication use in the prior month and exacerbations in the prior 12 months. Administrative data were also used to define medical utilization for asthma in year 3.
Of 13,833 eligible patients, 2895 (20.9%) returned the survey; 2751 of these respondents reported physician-diagnosed asthma, of whom 2517 (91.5%) had survey-defined persistent asthma. Patients having survey-defined persistent asthma (68.0%) were more likely to requalify as having HEDIS-defined persistent asthma in year 2 than patients not having survey-defined persistent asthma (22.2%). However, 81.6% of survey respondents who did not requalify as having HEDIS-defined persistent asthma in year 2 had survey-defined persistent asthma. Patients with survey-defined persistent asthma in year 2 had significantly more medical utilization for asthma in year 3 than patients without survey-defined persistent asthma. Approximately 82% of the 799 patients completing all 4 surveys had persistent asthma on all surveys.
HEDIS-defined persistent asthma is generally consistent with survey-defined persistent asthma. Persistent asthma usually remains persistent over a 3-year period, indicating that it is a stable characteristic of asthma for most patients. The low survey response rate suggests that further population-based studies will be necessary to confirm the validity and generalizability of our study findings regarding persistent asthma.
描述行政数据和调查数据定义的持续性哮喘之间的关系及其随时间的稳定性。
纵向调查和回顾性行政数据库。
行政数据用于确定符合医疗保健效果数据和信息集（HEDIS）标准的患者在第 1 年（2006 年）患有持续性哮喘。在第 2 年年末和第 3 年的 3 个时间点，通过邮寄调查来确定根据前 1 个月的症状和用药情况以及前 12 个月的加重情况定义持续性哮喘。还使用行政数据来确定第 3 年的哮喘医疗利用情况。
在 13833 名合格患者中，有 2895 名（20.9%）返回了调查；在这些应答者中，有 2751 名报告了医生诊断的哮喘，其中 2517 名（91.5%）有调查定义的持续性哮喘。患有调查定义的持续性哮喘（68.0%）的患者在第 2 年重新符合 HEDIS 定义的持续性哮喘的可能性高于没有调查定义的持续性哮喘的患者（22.2%）。然而，81.6%的在第 2 年未重新符合 HEDIS 定义的持续性哮喘的调查应答者仍有调查定义的持续性哮喘。在第 2 年患有调查定义的持续性哮喘的患者在第 3 年的哮喘医疗利用显著高于没有调查定义的持续性哮喘的患者。在完成所有 4 次调查的 799 名患者中，约有 82%在所有调查中均有持续性哮喘。
HEDIS 定义的持续性哮喘通常与调查定义的持续性哮喘一致。持续性哮喘通常在 3 年内保持持续性，表明它是大多数患者哮喘的一个稳定特征。低调查应答率表明，需要进一步进行基于人群的研究，以确认我们关于持续性哮喘的研究结果的有效性和普遍性。
