IngentaConnect Health-related quality of life and future health care utilization...

Authors: Eisner, Mark D.; Ackerson, Lynn M.¹; Chi, Felicia¹; Kalkbrenner, Amy¹; Buchner, Deborah²; Mendoza, Guillermo³; Lieu, Tracy⁴

Source: Annals of Allergy, Asthma and Immunology, Volume 89, Number 1, July 2002 , pp. 46-55(10)

Publisher: American College of Allergy, Asthma, & Immunology

Abstract:

Background: Although health-related quality of life (HRQL) has been increasingly used as an outcome in asthma, its utility for identifying patients at risk for adverse asthma outcomes has not been established.

Objective: In a prospective cohort study, to evaluate the longitudinal impact of HRQL on future health care utilization and cost among adults with asthma, accounting for known risk factors for utilization.

Methods: A stratified random sample of 3,482 adult Northern CA Kaiser Permanente members with asthma was selected using computerized utilization databases and a screening survey item. Subjects completed a mail survey that included measures of generic (SF-12) and asthma-specific HRQL (ITG-Asthma Short Form battery). During the 12 months after survey completion, computerized utilization and cost data were ascertained.

Results: Better baseline asthma-specific HRQL was associated with a decreased risk of asthma-related emergency department visit or hospitalization during longitudinal followup (odds ratio per 10-point score increment 0.84; 95% confidence interval [CI] 0.74 to 0.95), controlling for demographic and clinical factors. Better baseline generic physical HRQL was associated with a decreased risk of future all-cause hospitalization (odds ratio 0.68; 95% CI 0.60 to 0.77). More favorable asthma-specific HRQL scores were also related to decreased asthma-related health care costs during the ensuing year (-0.086 log-dollars per 10-point score increment; 95% CI -0.11 to -0.06). Better generic physical HRQL scores were associated with lower total costs (-0.24 log-dollars; 95% CI -0.32 to -0.17).

Conclusions: In a large cohort of adult health maintenance organization members with asthma, asthma-specific HRQL was associated with future asthma-related utilization and cost.

Document Type: Original article

Affiliations: 1: Division of Research, Kaiser Permanente, Oakland, California. 2: Integrated Therapeutics Group, Schering-Plough, Kenilworth, New Jersey. 3: Department of Allergy, Kaiser Permanente, Vacaville, California. 4: Harvard Pilgrim Health Care and Harvard University School of Medicine, Cambridge, Massachusetts.

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Health-related quality of life and future health care utilization for asthma