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  • Measure Summary
  • NQMC:001614
  • Jan 2003

Asthma: percent of patients evaluated for environmental triggers other than environmental tobacco smoke (dust mites, cats, dogs, molds/fungi, cockroaches) either by history of exposure and/or by allergy testing.

HDC topics: asthma. [internet]. Rockville (MD): HRSA Health Disparities Collaboratives; 2005 [accessed 2005 Mar 31]. [8 p].

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in October 2015.

Primary Measure Domain

Clinical Quality Measures: Process

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the percent of patients evaluated for environmental triggers other than environmental tobacco smoke (dust mites, cats, dogs, molds/fungi, cockroaches) either by history of exposure and/or by allergy testing.

Note: This measure and the "Exposure to Environmental Tobacco Smoke" measure (see the related National Quality Measures Clearinghouse [NQMC] summary of the HRSA HDC measure Asthma: percent of patients with a reported exposure to environmental tobacco smoke at last visit measure) can overlap with the "Current Self-management Goal" measure (see the related NQMC summary of the HRSA HDC measure Asthma: percent of patients with documented self-management goals in the last 12 months) in that a patient and provider can work to reduce exposure to a trigger as a self-management goal.

Rationale

Asthma is a chronic lung condition that increasingly is being recognized as a major international public health challenge. But although asthma is a chronic respiratory disease, much can be done to manage the symptoms. Never before have we had so many good, safe oral and inhaled drugs for the treatment of asthma as we do today. Evidence-based guidelines have been proven to be effective in improving the daily lives of patients with this disease.

Unfortunately, despite our progress, we know that many individuals with asthma still suffer unnecessarily from the symptoms of disease. Guideline implementation lags in many practices across the country. In a healthcare system designed around acute care, chronic illnesses including asthma are not managed as effectively as they could be. Translating research into practice is not as easy as it sounds, even when we know it is the right thing to do.

The Asthma Collaborative is designed to help healthcare providers improve the care they provide to people with asthma. Focusing on specific measures that are based on clinical guidelines, practices concentrate on changes that truly make a difference. By providing tools and proven strategies to change the way asthma care is delivered, the Asthma Collaborative has improved the lives of thousands with asthma.

This measure is one of 11 measures that participants track in the HRSA Health Disparities Collaborative for Asthma.

Evidence for Rationale

HDC topics: asthma. [internet]. Rockville (MD): HRSA Health Disparities Collaboratives; 2005 [accessed 2005 Mar 31]. [8 p].

Institute for Healthcare Improvement. Health Disparities Collaboratives changing practice, changing lives: asthma training manual. Cambridge (MA): Institute for Healthcare Improvement; 2002. 71 p.

Primary Health Components

Asthma; environmental triggers; assessment

Denominator Description

Total number of patients with asthma in the registry

Numerator Description

The number of patients from the denominator evaluated for environmental triggers other than environmental tobacco smoke (dust mites, cats, dogs, molds/fungi, cockroaches) either by history of exposure and/or by allergy testing

Note: The "indoor" environmental triggers here are those having the strongest evidence of causal relationship to asthma.

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A clinical practice guideline or other peer-reviewed synthesis of the clinical research evidence
  • A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences
  • One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal

Additional Information Supporting Need for the Measure

  • Asthma affects between 14 and 15 million people in the United States alone. There are 4.8 million children with asthma in the U.S. During the past 15 years, its prevalence around the world has doubled.
  • In the U.S., rates of asthma deaths, hospitalizations, and emergency department visits have been increasing for more than two decades, especially among African Americans and children. Since 1979–82, the average age-adjusted asthma death rate for blacks has increased 71 percent versus 41 percent for Caucasians, and in 1995–98, the death rate was almost three times that of Caucasians.
  • Similarly, between 1992 and 1998, rates of emergency department visits for asthma increased, with the greatest increase in children ages 10–17. Children under 5 accounted for the highest rates of emergency department visits. Hospitalization rates also rose during this time period. Between 1979–81 and 1997–99, hospitalization rates for children under 5 increased 48 percent. In 1997–99, hospitalization rates were more than three times higher for African Americans than for whites.
  • In 2000, there were 100 million total days of restricted activity among persons with asthma and 5,000 deaths of asthma.
  • In 2000, the annual hospitalization rate among persons with asthma was 470,000.
  • The total cost of asthma in 2000 was estimated to be $12.7 billion, with direct medical costs amounting to $8.1 billion and lost earnings due to illness and death totaling $4.6 billion.

Evidence for Additional Information Supporting Need for the Measure

HDC topics: asthma. [internet]. Rockville (MD): HRSA Health Disparities Collaboratives; 2005 [accessed 2005 Mar 31]. [8 p].

Institute for Healthcare Improvement. Health Disparities Collaboratives changing practice, changing lives: asthma training manual. Cambridge (MA): Institute for Healthcare Improvement; 2002. 71 p.

Extent of Measure Testing

Unspecified

State of Use

Current routine use

Current Use

Collaborative inter-organizational quality improvement

Internal quality improvement

Measurement Setting

Ambulatory/Office-based Care

Community Health Care

Professionals Involved in Delivery of Health Services

Advanced Practice Nurses

Physician Assistants

Physicians

Least Aggregated Level of Services Delivery Addressed

Clinical Practice or Public Health Sites

Statement of Acceptable Minimum Sample Size

Unspecified

Target Population Age

Unspecified

Target Population Gender

Either male or female

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Person- and Family-centered Care
Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Living with Illness

IOM Domain

Effectiveness

Equity

Patient-centeredness

Case Finding Period

The last workday of each month

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Clinical Condition

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Total number of patients with asthma in the registry

Exclusions
Unspecified

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
The number of patients from the denominator evaluated for environmental triggers other than environmental tobacco smoke (dust mites, cats, dogs, molds/fungi, cockroaches) either by history of exposure and/or by allergy testing

Note: The "indoor" environmental triggers here are those having the strongest evidence of causal relationship to asthma.

Exclusions
Unspecified

Numerator Search Strategy

Fixed time period or point in time

Data Source

Registry data

Type of Health State

Does not apply to this measure

Instruments Used and/or Associated with the Measure

Unspecified

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Desired value is a higher score

Allowance for Patient or Population Factors

Unspecified

Standard of Comparison

Internal time comparison

Prescriptive standard

Prescriptive Standard

Goal: greater than 90%

Evidence for Prescriptive Standard

HDC topics: asthma. [internet]. Rockville (MD): HRSA Health Disparities Collaboratives; 2005 [accessed 2005 Mar 31]. [8 p].

Original Title

Evaluation of environmental triggers.

Measure Collection Name

HRSA Health Disparities Collaboratives (HDC) Measures

Measure Set Name

HRSA HDC Asthma Collaborative Measures

Submitter

Health Resources and Services Administration - Federal Government Agency [U.S.]

Developer

HRSA Health Disparities Collaboratives: Asthma Collaborative - Federal Government Agency [U.S.]

Funding Source(s)

Unspecified

Composition of the Group that Developed the Measure

Unspecified

Financial Disclosures/Other Potential Conflicts of Interest

Unspecified

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2003 Jan

Measure Maintenance

Unspecified

Date of Next Anticipated Revision

Unspecified

Measure Status

This is the current release of the measure.

The measure developer reaffirmed the currency of this measure in October 2015.

Source(s)

HDC topics: asthma. [internet]. Rockville (MD): HRSA Health Disparities Collaboratives; 2005 [accessed 2005 Mar 31]. [8 p].

Measure Availability

Source not available electronically.

For more information, contact the Health Resources and Services Administration at 5600 Fishers Lane, Room 7-100, Parklawn Building, Rockville, MD 20857; Phone: 888-275-4772.

Companion Documents

The following is available:

  • Institute for Healthcare Improvement. Health Disparities Collaboratives changing practice, changing lives: asthma training manual. Cambridge (MA): Institute for Healthcare Improvement; 2004. 71 p.

NQMC Status

This NQMC summary was completed by ECRI on July 5, 2006. The information was verified by the measure developer on August 18, 2006.

This NQMC summary was retrofitted into the new template on July 13, 2011.

The information was reaffirmed by the measure developer on October 28, 2015.

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No copyright restrictions apply.

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