ORIGINAL ARTICLES
Assessing the quality of asthma care provided to Medicaid patients enrolled in managed care organizations in Connecticut

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Background

Many states have enrolled Medicaid beneficiaries in managed care organizations (MCOs). Few assessments of the quality of asthma care provided by these new programs are available.

Objective

To describe the quality of care provided to asthmatic Medicaid children enrolled in MCOs.

Methods

For this cross-sectional survey, a chart abstraction tool was developed to evaluate fulfillment of key performance measures chosen from a national guideline for asthma diagnosis and management. These measures were prescription of an inhaled anti-inflammatory medication, accomplishment of patient education, evaluation of exposure to environmental triggers of asthma, and administration of influenza vaccination. From State of Connecticut administrative databases, a random sampling of Medicaid children, ages 5 to 18 years, enrolled in four MCOs was selected. Chart entries from July 1, 1996 to June 30, 1997 were reviewed using the abstraction tool. Accomplishment of performance measures was evaluated for the total sample and for children who were high utilizers of medical services (at least one ED visit or hospitalization during the study period).

Results

For 80 high utilizers among 315 children, completion of performance measures was suboptimal: 46% were prescribed inhaled steroids; an action plan was outlined for 43%; evaluation of patient or family tobacco use was documented for 56%; evaluation of the presence of a pet for 43% or mite exposure for 19%; and allergy skin testing or RAST was accomplished for 15%.

Conclusions

This information suggests that opportunities exist to improve the quality of care for these children.

REFERENCES (31)

  • PJ Gergen et al.

    Changing patterns of asthma hospitalization among children: 1979–87

    JAMA

    (1990)
  • Office of Health Care Access, State of Connecticut. Asthma, a growing health concern in Connecticut. Issue Brief No.10,...
  • EF Crain et al.

    Reported difficulties in access to quality care for children with asthma in the inner city

    Arch Pediatr Adolesc Med

    (1998)
  • PA Eggleston et al.

    Medications used by children with asthma living in the inner city

    Pediatrics

    (1998)
  • JA Finkelstein et al.

    Quality of care for preschool children with asthma: the role of social factors and practice setting

    Pediatrics

    (1995)
  • Cited by (0)

    The preparation of this report was financed under an agreement with the Connecticut Department of Social Services.

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