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Methods Aimed at Improving Asthma Care and Outcomes Management

A Case Study

  • Original Research Article
  • Published:
Disease Management & Health Outcomes

Abstract

Objectives: To compare the experience of one managed care organization (MCO) [Anthem Blue Cross and Blue Shield Midwest Region] to the experience of a reference group of 15 other MCOs participating in a study designed to test the usefulness of outcomes management information in developing and implementing interventions to improve the quality of care in asthma.

Study design: Prospective study.

Patients and methods: Adult patients with moderate or severe asthma enrolled in sixteen participating MCOs who completed an initial baseline survey in 1993 and follow-up surveys in 1994 and 1995. Data analyses focused on differences between Anthem and the reference group at each round of data collection as well as longitudinal analyses of changes over time.

Results: Baseline data suggested some deficiencies in care at all MCO sites. Cross-sectional comparisons between Anthem and the reference group revealed statistically significant differences in outcomes measures (hospitalization and emergency room visits, canceled activities per month because of asthma, asthma attacks per month, and work days lost in the past month). Improvements in these outcomes were reported over the subsequent two years. Patients at Anthem reported a significantly greater increase in peak flow meter (PFM) possession than did those in the reference group (p = 0.01) which may have resulted from an administrative change that made PFMs a funded item. However, other interventions (e.g. educational programs) may have also contributed to the improvements.

Conclusions: This study illustrates the ability of MCOs to collect and use patient-reported outcomes data to monitor and improve patient care. Such information allowed this national group of participating MCOs to identify deficiencies in quality of care provided, design tailored interventions and measure the potential impact of these interventions on patient care.

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Acknowledgements

The authors gratefully acknowledge Becky Clark for her assistance with data management for this study.

This study was funded by the Employers Managed Health Care Association Outcomes Management System consortium. It was also funded, in part, by an unrestricted research grant from Anthem Blue Cross and Blue Shield Midwest Region.

Robert C. McDonald was an employee of Anthem Blue Cross and Blue Shield at the time this study was performed and is currently employed by Anthem Inc.

Author information

Authors and Affiliations

  1. U.S. Human Health, Outcomes Research & Management, Merck & Co., Inc., West Point, Pennsylvania, USA

    Felicia C. Allen-Rameym

  2. Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA

    Gregory B. Diette

  3. Anthem Blue Cross and Blue Shield Midwest Region, Indianapolis, Indiana, USA

    Robert C. McDonald

  4. Division of Pulmonary, Critical Care, Occupational Medicine and Allergy, Indiana University Medical School, Indianapolis, Indiana, USA

    Robert C. McDonald

  5. Regenstrief Institute for Health Care, Indianapolis, Indiana, USA

    Robert C. McDonald

  6. Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA

    Elizabeth A. Skinner, Donald M. Steinwachs & Albert W. Wu

  7. Johns Hopkins Bloomberg School of Public Health, Health Services Research and Development Center, 624 N. Broadway/ Room 633, Baltimore, MD, 21205-1996, USA

    Albert W. Wu

Authors
  1. Felicia C. Allen-Rameym
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  2. Gregory B. Diette
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  3. Robert C. McDonald
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  4. Elizabeth A. Skinner
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  5. Donald M. Steinwachs
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  6. Albert W. Wu
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Corresponding author

Correspondence to Albert W. Wu.

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Allen-Rameym, F.C., Diette, G.B., McDonald, R.C. et al. Methods Aimed at Improving Asthma Care and Outcomes Management. Dis-Manage-Health-Outcomes 10, 495–503 (2002). https://doi.org/10.2165/00115677-200210080-00006

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  • DOI: https://doi.org/10.2165/00115677-200210080-00006

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