Objective: To demonstrate the utility of a combined pharmacy and medical claims database in the assessment of the incidence and the cost centers of asthma care in a managed health care system.
Design: A retrospective observational study to document annual cost for asthma therapy by cost center during 1993.
Setting: Four affiliated health maintenance organizations.
Participants: A total of 25,614 asthmatics identified from a population of approximately 673,000 members in the health maintenance organization.
Main outcome measure: Annual charges by cost center for asthma care analyzed by age and gender.
Results: The period prevalence of asthma was 3.8%. Annual direct medical charges for asthma were $467.40 per member. Inpatient hospital and emergency department charges were greater in children than adults. Adolescent girls had increased use of the emergency department and inpatient hospital facilities and lower charges for medications than their male counterparts. Their increased use of acute care facilities was responsible for 25% greater charges for total asthma care. The gender differences in cost centers continued for adults, with increased charges for inpatient hospital and emergency department charges and lower expenses for medications for women.
Conclusions: Charges for acute care were inversely related to the dollars spent on pharmaceuticals. This study demonstrates the ability of a combined medical and pharmacy database to document the charges for care and possibly identify indicators of undertreated populations.