Attainment of asthma-specific US Healthcare Effectiveness Data and Information Set (HEDIS) quality measures may be associated with improved clinical outcomes and reduced economic burden.
We examined the relationship between attainment of HEDIS measures Asthma Medication Ratio (AMR) and Medication Management for People with Asthma (MMA) on clinical and economic outcomes.
This retrospective claims database analysis linked to ambulatory electronic medical records enrolled US patients ≥5 years with persistent asthma between May-2015 and Apr-2017. Attainment of AMR ≥0.5 and MMA ≥75% was determined over a 1-year premeasurement period. Asthma exacerbations, and asthma-related healthcare costs were evaluated during the subsequent 12-month measurement period, comparing patient attaining one or both measures with those not attaining either.
In total, 32,748 patients were included, 75.2% of whom attained AMR (n=24,388) and/or MMA (n=12,042) during the premeasurement period. Fewer attainers of one or more HEDIS measure had ≥1 asthma-related hospitalization, emergency department visit, corticosteroid burst or exacerbation (4.9% vs. 7.3%; 9.6% vs. 18.2%; 43.8% vs. 51.6%; 14.3% vs. 23.3%; respectively, all p<.001) compared with non-attainers. In adjusted analyses, HEDIS attainment was associated with a lower likelihood of exacerbations (odds ratio: 0.63, [95% CI: 0.60‒0.67] p<.001). Attainment of ≥1 HEDIS measure lowered total and asthma-related costs, and asthma exacerbation-related healthcare costs per patient relative to non-attainers (cost ratio: 0.87, p<.001; 0.96, p=0.02; and 0.59; p<.001, respectively). Overall and asthma-specific costs were lower for patients attaining AMR, but not MMA.
HEDIS attainment was associated with significantly improved asthma outcomes and lower asthma-specific costs.
Copyright © 2020. Published by Elsevier Inc.