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Hospitalization

Description:

Our hospitalization measure uses claims data to determine the percentage of patients in our population (Adult Asthma, Pediatric Asthma, and COPD) who were discharged from the hospital with a disease-related diagnosis.  A lower proportion indicates a better performance.

Population Specifics:

  • 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 age 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/Denomenator:

  • Numerator: All patients aged 2 years and older with COPD or Asthma that have at least one claim for hospitalization in the measurement year or the year prior.
  • Denominator: All patients aged 2 years and older with COPD or Asthma in the measurement year.

Rationale:

  • 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).

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4251 Plymouth Rd.
Ann Arbor, MI 48105

Support for the INHALE CQI is provided by Blue Cross Blue Shield of Michigan as part of the BCBSM Value Partnerships program. BCBSM’s Value Partnerships program provides clinical and executive support for all CQI programs. 

Although Blue Cross Blue Shield of Michigan and the INHALE CQI work in partnership, the opinions, beliefs, and viewpoints expressed by INHALE CQI do not necessarily reflect the opinions, beliefs, and viewpoints of BCBSM or any of its employees.