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A Survey of Medicaid Recipients With Asthma^*

Perceptions of Self-Management, Access, and Care

^* From the Office of Managed Care (Mr. Anarell, Mr. Roohan and Dr. Gesten), New York State Department of Health, Albany, NY; and the Managed Care Department (Dr. Balistreri), Island Peer Review Organization, Lake Success, NY.

Correspondence to: Joseph Anarella, MPH, Assistant Director, Bureau of Quality Management and Outcomes Research, Office of Managed Care, New York State Department of Health, Corning Tower, Rm 1955, Empire State Plaza, Albany, NY 12237; e-mail: JPA02{at}health.state.ny.us

Study objectives: To understand how Medicaid recipients with asthma view their experience with care.

Design: Survey sent to Medicaid managed care enrollees.

Setting: A survey designed to assess general health status, access to care, medication-taking behaviors, and overall satisfaction was sent to 25,171 patients with moderate-to-severe asthma.

Results: A total of 92% of patients rated their asthma care as good or excellent, 64% of adults reported their health as fair or poor, while only 27% of children reported their health as being fair or poor. Respondents were well-educated regarding their asthma, with 87% reporting knowing what to do for severe asthma attacks, 78% knowing the early warning signs of an asthma attack, and 77% recognizing aggravating factors. Eighty-nine percent of respondents rated the quality of the information given to them by their provider as very good or good. While 75% of patients reported using inhaled steroids, only 38% of those reported using them on a daily basis. Forty percent of patients reported using inhaled steroids only when they have symptoms. Forty-six percent of adults either smoke cigarettes or are exposed to smoking in the home, while 35% of children are exposed to smoke in the home.

Conclusion: Asthmatic patients rated the quality of the information that their physicians provide very highly and reported that that they understand how to treat exacerbations. However, they do not take prescribed inhaled steroids on a daily basis. In addition, many asthmatic patients reside in homes where cigarette smoking is present.

Key Words: asthma • Medicaid managed care • survey

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