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首页> 外文期刊>Journal of public health management and practice: JPHMP >Using medicaid claims to identify children with asthma
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Using medicaid claims to identify children with asthma

机译：使用医疗补助声明来识别儿童哮喘

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Objective: To assess the accuracy of using administrative data from state-managed programs to identify children with asthma in a statewide immunization information system. We wished to understand the degree to which alternative asthma case definitions applied to administrative data influence the accuracy of cases identified in an immunization information system. Design and Setting: Children aged 2 to 18 years were sequentially classified into 3-case definition groups on the basis of Michigan Department of Community Health administrative data (2005-2006): (1) children with a Childrens Special Health Care Services (CSHCS) Program qualifying diagnosis of asthma (CSHCS cases); (2) those having 1 or more asthma medication claims (Rx cases); or (3) those without asthma medications having 1 or more health services claim reporting an asthma diagnosis code (Dx cases). Participants: Children were randomly selected from each asthma case definition group; parents were invited to participate in a telephone interview to document physician diagnosis of asthma, symptoms, activity limitations, medications, and asthma health services use. Main Outcome Measures: The positive predictive value of parent report of a physician diagnosis of asthma; asthma severity, based on National Asthma Education and Prevention Program criteria. Results: Of 440 completed interviews, 89% of parents confirmed the childs high-risk status, reporting physician diagnosis of asthma (83%), wheezy-cough (5%), or reactive airway disease (1%). The positive predictive value varied for CSHCS cases (100%), Rx cases (91%) and Dx cases (73%, P < .0001). Although reported asthma severity levels were similar among CSHCS and Rx cases (P = .9100), asthma severity was lower among Dx cases (P = .0218). Conclusions: Medicaid administrative data can be used to accurately identify children with asthma and represents a feasible approach for Medicaid programs and health plans to identify priority groups for targeted influenza vaccination reminders.
机译：目的：评估在州级免疫信息系统中使用州政府管理计划中的行政数据鉴定哮喘患儿的准确性。我们希望了解适用于行政数据的替代性哮喘病例定义在多大程度上影响了免疫信息系统中鉴定出的病例的准确性。设计与设置：根据密歇根州社区卫生部的行政数据（2005-2006年），将2至18岁的儿童按年龄分为3个病例组：（1）具有儿童特殊保健服务（CSHCS）的儿童哮喘的计划合格诊断（CSHCS病例）; （2）申领1项或以上哮喘药物的患者（Rx例）;或（3）那些没有哮喘药物且具有一种或多种保健服务的患者声称报告了哮喘诊断代码（Dx病例）。参与者：从每个哮喘病例定义组中随机选择儿童;邀请父母参加电话采访，以记录医师对哮喘的诊断，症状，活动受限，药物和哮喘保健服务的使用。主要观察指标：医生诊断为哮喘的父母报告的阳性预测价值;根据国家哮喘教育和预防计划标准确定的哮喘严重程度。结果：在440次完整的访谈中，有89％的父母确认了孩子的高危状态，并报告了医师诊断为哮喘（83％），喘息咳嗽（5％）或反应性气道疾病（1％）。 CSHCS病例（100％），Rx病例（91％）和Dx病例（73％，P <.0001）的阳性预测值不同。尽管在CSHCS和Rx病例中报告的哮喘严重程度水平相似（P = .9100），但在Dx病例中哮喘严重程度较低（P = .0218）。结论：Medicaid行政数据可用于准确识别哮喘患儿，并代表Medicaid计划和健康计划确定针对性流感疫苗提醒的优先人群的可行方法。

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