Chest
Original ResearchPulmonary Function TestingSpirometry Utilization for COPD: How Do We Measure Up?
Section snippets
Materials and Methods
In the spring of 2004, the NCQA received expedited institutional review board approval to conduct a research study to investigate the feasibility of implementing a health plan performance measure to encourage use of spirometry testing during initial diagnosis and assessment for COPD. The research study did not involve human subjects, relying instead on retroactive review of existing patient-level data.
The NCQA recruited health plans to test the feasibility of a measure that would assess the
Results
In total, participating health plans covered 1,424,513 members who were commercially insured, 83,621 who received Medicaid, and 89,615 who received Medicare. A total of 5,039 eligible patients (3,559 commercial, 347 Medicaid, and 1,403 Medicare) with a new diagnosis of COPD during the study period were identified (Table 1). Sixty-five percent of patients were in the 40 to 64 year age range, and 53% were female. The age distributions within insurers show that as expected, the Medicare population
Discussion
Our study has several key findings, most notably that spirometry is uncommonly used for the diagnosis of COPD in managed care plans in the United States. In the participating health plans, the average rate of spirometry documentation in the 2 years prior to a new COPD diagnosis ranged from 26 to 38% between health plans. Importantly, altering the time of the negative diagnostic history had little effect on the overall utilization of spirometry. These data confirm those of another recent report8
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