Use of a pharmacy and medical claims database to document cost centers for 1993 annual asthma expenditures
D. A. Stempel, E. C. Hedblom, J. F. Durcanin-Robbins and L. L. Sturm
Virginia Mason Medical Center, Seattle, WA, USA.
OBJECTIVE: To demonstrate the utility of a combined pharmacy and medical
claims database in the assessment of the incidence and the cost centers of
asthma care in a managed health care system. DESIGN: A retrospective
observational study to document annual cost for asthma therapy by cost
center during 1993. SETTING: Four affiliated health maintenance
organizations. PARTICIPANTS: A total of 25,614 asthmatics identified from a
population of approximately 673,000 members in the health maintenance
organization. INTERVENTIONS: None. MAIN OUTCOME MEASURE: Annual charges by
cost center for asthma care analyzed by age and gender. RESULTS: The period
prevalence of asthma was 3.8%. Annual direct medical charges for asthma
were $467.40 per member. Inpatient hospital and emergency department
charges were greater in children than adults. Adolescent girls had
increased use of the emergency department and inpatient hospital facilities
and lower charges for medications than their male counterparts. Their
increased use of acute care facilities was responsible for 25% greater
charges for total asthma care. The gender differences in cost centers
continued for adults, with increased charges for inpatient hospital and
emergency department charges and lower expenses for medications for women.
CONCLUSIONS: Charges for acute care were inversely related to the dollars
spent on pharmaceuticals. This study demonstrates the ability of a combined
medical and pharmacy database to document the charges for care and possibly
identify indicators of undertreated populations.
