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APHA Scientific Session and Event Listing

M. Beth Benedict, DrPH, JD, RN, Office of Research, Development and Information, Centers for Medicare & Medicaid Services, 867 DeFranceaux Harbour, Riviera Beach, MD 21122, 410-786-7724, beth.benedict@cms.hhs.gov

This retrospective study developed national statistics on asthma-related ambulatory and acute care, and expenditures. The analyses used the administrative enrollment and claims files from the 2001 CMS Medicaid Analytic eXtract (MAX) database. It is in a national uniform format to support multi-state analyses and includes fee-for-service, primary care case management, and encounter care claims reported by the States. The study population (1,522,174) had at least one ambulatory or one acute care claim with a primary diagnosis of asthma (any ICD- 493 codes): The ambulatory care analyses included 6,259,514 claims among 1,566,456 asthmatics (> $140 million). The acute care analyses included 131,927 claims for 97,349 asthmatics (>$200 million). Detailed analyses produced service and expenditure rates by age groups (preschoolers, grade schoolers, adolescents, non-elderly adults, and the aged); and, by gender and race/ethnicity. Ambulatory care findings: Age-race adjusted rates per 1,000 total enrollees showed that boys had 85 ambulatory care services compared with 56 by girls; Black youth had 45 services compared with 49 by Whites; and, adult women had 91 services compared with 24 by male adults. For acute care the age-race adjusted rates per 1000 enrollees showed boys had 1.7 stays compared with 1.05 by girls; and, Black children/adolescents had 1.11 stays compared with 0.79 stays by Whites; and, middle-aged Black women had the highest rates among adults. Minorities are accessing ambulatory care = a national goal in Healthy People 2010. As ambulatory access for asthma care increases, hopefully, overtime Medicaid use and expenditures for acute care will decrease.

Learning Objectives: At the completion of this presentation the learner will be able to

• Discuss rates of access to needed health care for asthma among Medicaid youth and adults, males and females, and minority and non-minority groups - with a comparison to Healthy People 2010 (Goal 24-2 reducing acute stays and, Developmental Goal 24-8 tracking...access to medical care for asthma).
• Discuss the likelihood of Medicaid Blacks and Hispanics having an acute care stay as compared with Whites, and the associated public state and federal expenditures for these enrollees.

Keywords: Access and Services, Medicaid

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: There is no off-label/investigational product use in this presentation.

Any relevant financial relationships? No