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(Chest. 2006;129:918-924.)
© 2006 American College of Chest Physicians

Using an Asthma Control Questionnaire and Administrative Data To Predict Health-Care Utilization*

Dawn Peters, PhD; Chuhe Chen, PhD; Leona E. Markson, ScD; Felicia C. Allen-Ramey, PhD and William M. Vollmer, PhD

* From Kaiser Permanente Center for Health Research (Drs. Chen and Vollmer), Portland, OR; Merck & Co., Inc. (Drs. Markson and Allen-Ramey), West Point, PA; and Oregon Health Sciences University (Dr. Peters), Portland, OR.

Correspondence to: Dawn Peters, PhD, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3098; e-mail: petersd{at}ohsu.edu

Abstract

Objective: To examine the merits of the Asthma Therapy Assessment Questionnaire (ATAQ) control index together with prior asthma health-care utilization from administrative data in predicting future acute asthma health-care utilization.

Design: Prospective cohort study.

Population: A total of 4,788 adult asthma patients aged 17 to 93 years who completed a baseline evaluation and had at least 6 months of follow-up data.

Statistical methods: Classification and regression tree methodology to predict future risk of acute health-care utilization events.

Results: These results show that the ATAQ control index and administrative data are jointly useful for predicting future health-care utilization. The utility of the ATAQ control index in the presence of information about prior health-care utilization is to further stratify risk among the subset of younger individuals who did not have any prior acute health-care utilization. While administrative health-care utilization data served as the strongest predictor of future health-care utilization, the ATAQ control index helped to identify 1% of individuals without recent acute care that had approximately a sixfold elevated risk (95% confidence interval, 4.2 to 8.4) of future acute health-care utilization. This is an important result since only a small fraction of individuals with acute events in a given year will have had acute events in the previous year.

Conclusion: These findings should assist the practicing clinician and organizations interested in population-based asthma disease management.

Key Words: asthma • asthma disease management • health-care utilization • level of control • severity




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[Abstract] [Full Text] [PDF]


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