Our emergency department visit measure uses claims data to determine the percentage of patients in our population (Adult Asthma, Pediatric Asthma, and COPD) who were seen in the ED for an exacerbation. A lower proportion indicates better performance.
- Asthma patients, regardless of severity, aged 2 and older with a primary diagnosis of asthma or a secondary diagnosis of asthma exacerbation in the measurement year.
- COPD patients aged 40 years and older with a primary diagnosis of COPD or primary diagnosis of acute respiratory failure and a secondary diagnosis of COPD in the measurement year.
- Numerator: All patients aged 2 years and older with COPD or Asthma that have at least one claim for an ED visit in the measurement year or the year prior.
- Denominator: All patients aged 2 years and older with COPD or Asthma in the measurement year.
- COPD (GOLD 2023): Exacerbations significantly impact the health status of the patient. Enhance the rate of lung function decline, worsen prognosis of the patient and are associated with most of the healthcare costs of COPD. The best predictor of having frequent exacerbations (defined as two or more exacerbations per year) is the previous history of exacerbations. Worsening of airflow obstruction is associate with an increasing prevalence of exacerbations, hospitalization and risk of death. (p 40)
- Asthma (GINA 2022):
- Uncontrolled asthma is defined by poor symptoms control (frequent symptoms or reliever use, activity limited by asthma, night waking due to asthma) and frequent exacerbations (2 or more per year) requiring OCS, or serious exacerbations (one or more per year) requiring hospitalization (Pg. 105).
- Poor asthma symptom control itself substantially increases the risk of exacerbations. The risk of severe exacerbation and mortality increases incrementally with higher SABA use, independent of treatment step (Pg. 38).