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Asthma Surveillance in the West
Virginia Medicaid Population – Year 2002
|
TOTAL ASTHMA UTILIZATION Based on recipients identified with asthma by the presence of at least one claim for medical services with a primary or secondary diagnosis of asthma OR at least two prescription claims for asthma-related medications |
||||
Type of utilization | Number of recipients with
asthma (N) |
Prevalence rate per 1,000 Medicaid recipients | Total amount reimbursed
by Medicaid ($) |
Average amount reimbursed
per recipient ($) |
---|---|---|---|---|
Total asthma utilization | 42,312 | 118.7 | 28,304,831 | 669 |
MEDICAL VISIT UTILIZATION Based on services with a primary or secondary diagnosis of asthma |
||||
Type of utilization | Number of visits (N) |
Rate of visits per 10,000 Medicaid recipients | Total amount reimbursed
by Medicaid ($) |
Average amount reimbursed
per visit ($) |
Outpatient Visits | 35,723 | 1,002.0 | 3,431,757 | 96 |
Emergency room visits | 5,642 | 158.3 | 1,007,981 | 179 |
Hospitalizations | 1,702 | 47.8 | 7,941,660 | 4,666 |
PRESCRIPTION UTILIZATION Based on recipients with at least two prescription claims for asthma-related medications, at least one of which was for a drug other than an oral steroid. |
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Type of utilization |
Number of prescription claims
for asthma-related drugs (N) |
Average number of claims per recipient | Total amount reimbursed
($) |
Average amount reimbursed
per recipient ($) |
Prescriptions | 312,112 | 9.3 | 15,353,608 | 457 |
Overall burden of asthma in the West Virginia Medicaid population
Table 2. Prevalence rates of asthma in the West Virginia Medicaid population and total Medicaid reimbursements for asthma-related services – By demographic category, 2002
Demographic variables | Number of recipients with asthma2 (N) |
Prevalence rate per 1,000 Medicaid recipients3 4 | Total amount reimbursed5 ($) |
Average amount reimbursed per recipient6 ($) |
---|---|---|---|---|
Age (years) | ||||
0-14 | 14,642 | 94.6 | 8,155,973 | 557 |
15-20 | 2,962 | 74.7 | 1,206,971 | 407 |
21-64 | 18,439 | 147.4 | 14,387,829 | 780 |
≥ 65 | 6,247 | 169.1 | 4,544,551 | 727 |
Unknown | 22 | -- | 9,507 | 432 |
Gender | ||||
Male | 17,340 | 115.1 | 10,843,507 | 625 |
Female | 24,535 | 119.3 | 17,165,038 | 700 |
Unknown | 437 | -- | 296,286 | 678 |
> | ||||
Race | ||||
White | 39,575 | 119.8 | 26,446,302 | 668 |
Black | 1,752 | 97.9 | 1,221,682 | 697 |
Other | 464 | -- | 322,964 | 696 |
Unknown | 521 | -- | 313,883 | 602 |
Total | 42,312 | 118.7 | 28,304,831 | 669 |
Figure 1. Prevalence rates of asthma in the West Virginia Medicaid population – By demographic category, 20027
Figure 2. Total reimbursements for asthma-related health care by West Virginia Medicaid – By demographic category, 20028
Outpatient visits for asthma in the West Virginia Medicaid population
Table 3. Utilization of outpatient services for asthma among recipients of West Virginia Medicaid and reimbursements by Medicaid for the same – By demographic category, 2002
Demographic Variables | Number of outpatient
visits9 (N) |
Rate of outpatient visits per 1,000 recipients10 ,11 | Total amount reimbursed12 ($) |
Average amount reimbursed
per visit13 ($) |
---|---|---|---|---|
Age (years) | ||||
0-14 | 11,930 | 77.1 | 1,432,720 | 120 |
15-20 | 2,409 | 60.8 | 252,091 | 105 |
21-64 | 18,230 | 145.8 | 1,618,091 | 89 |
≥ 65 | 3,136 | 84.9 | 127,637 | 41 |
Unknown | 18 | -- | 1,219 | 68 |
Gender | ||||
Male | 12,875 | 85.5 | 1,332,023 | 103 |
Female | 22,277 | 108.3 | 2,067,287 | 93 |
Unknown | 571 | -- | 32,447 | 57 |
Race | ||||
White | 33,541 | 101.5 | 3,222,950 | 96 |
Black | 1,385 | 77.4 | 150,045 | 108 |
Other | 356 | -- | 21,931 | 62 |
Unknown | 441 | -- | 36,831 | 84 |
Total | 35,723 | 100.2 | 3,431,757 | 96 |
Emergency room (ER) visits for asthma in the West Virginia Medicaid population
Table 4. Utilization of ER services for asthma among recipients of West Virginia Medicaid and reimbursements by Medicaid for the same – By demographic category, 2002
Demographic Variables | Number of ER visits14 (N) |
Rate of ER visits per 10,000 recipients15 ,16 | Total amount reimbursed17 ($) |
Average amount reimbursed
per visit18 ($) |
---|---|---|---|---|
Age (years) | ||||
0-14 | 2,184 | 141.1 | 340,504 | 156 |
15-20 | 499 | 125.9 | 84,538 | 169 |
21-64 | 2,754 | 220.2 | 542,326 | 197 |
≥ 65 | 203 | 55.0 | 40,416 | 199 |
Unknown | 2 | -- | 196 | 98 |
Gender | ||||
Male | 2,113 | 140.3 | 353,276 | 167 |
Female | 3,470 | 168.7 | 642,612 | 185 |
Unknown | 59 | -- | 12,093 | 205 |
Race | ||||
White | 5,079 | 153.8 | 906,229 | 178 |
Black | 427 | 238.7 | 74,255 | 174 |
Other | 56 | -- | 10,471 | 187 |
Unknown | 80 | -- | 17,025 | 213 |
|
||||
Total | 5,642 | 158.3 | 1,007,981 | 179 |
Hospitalizations for asthma in the West Virginia Medicaid population
Table 5. Utilization of inpatient services for asthma among recipients of West Virginia Medicaid and reimbursements by Medicaid for the same – By demographic category, 2002
Demographic variables | Number of hospital visits19 (N) |
Rate of hospital visits per 10,000 recipients20 ,21 | Total amount reimbursed22
($) |
Average amount reimbursed per visit23 ($) |
Average length of stay (ALOS) per visit24 |
---|---|---|---|---|---|
Age (years) | |||||
0-14 | 569 | 36.8 | 2,483,812 | 4,365 | 2.7 |
15-20 | 50 | 12.6 | 197,974 | 3,959 | 2.4 > |
21-64 | 881 | 70.4 | 4,215,180 | 4,785 | 4.7 |
≥ 65 | 201 > | 54.4 | 1,042,422 | 5,186 | 5.3 |
Unknown | 1 | -- | 2,272 | 2,272 | 4.0 |
Gender | |||||
Male | 583 | 38.7 | 2,719,709 | 4,665 | 3.4 |
Female | 1,098 | 53.4 | 5,120,029 | 4,663 | 4.5 |
Unknown | 21 | -- | 101,921 | 4,853 | 4.6 > |
Race | |||||
White | 1,572 | 47.6 | 7,255,182 | 4,615 | 4.1 |
Black | 93 | 52.0 | 513,408 | 5,521 | 4.5 |
Other | 19 | -- | 99,369 | 5,230 | 4.9 |
Unknown | 18 | -- | 73,701 | 4,095 | 3.7 |
Total | 1,702 | 47.8 | 7,941,660 | 4,666 | 4.1 |
Prescription utilization patterns among West Virginia Medicaid recipients who had at least two prescription claims for asthma-related medications
Table 6. Asthma-related prescription utilization patterns among West Virginia Medicaid recipients who had at least two prescription claims for asthma-related drugs and reimbursements by Medicaid for the same – By demographic category, 2002
Demographic Variables | Number of recipients
with asthma25 (N1) |
Number of prescription
claims26 (N 2 ) |
Average number of claims per recipient27 | Total amount reimbursed28 ($) |
Average amount reimbursed
per recipient29 ($) |
---|---|---|---|---|---|
Age (years) | |||||
0-14 | 10,535 | 64,604 | 6.1 | 3,629,416 | 345 |
15-20 | 2,135 | 13,371 | 6.3 | 631,725 | 296 |
21-64 | 15,218 | 160,224 | 10.5 | 7,779,973 | 511 |
≥ 65 | 5,666 | 73,777 | 13.0 | 3,306,932 | 584 |
Unknown | 16 | 136 | 8.5 | 5,562 | 348 |
|
|
|
|
|
|
Gender |
|
|
|
|
|
Male |
13,672 |
122,688 |
9.0 |
6,216,245 |
455 |
Female |
19,592 |
186,380 |
9.5 |
8,990,661 |
459 |
Unknown |
306 |
3,044 |
9.9 |
146,702 |
479 |
|
|
|
|
|
|
Race |
|
|
|
|
|
White |
31,461 |
295,158 |
9.4 |
14,544,609 |
462 |
Black |
1,303 |
9,026 |
6.9 |
441,777 |
339 |
Other |
385 |
4,101 |
10.7 |
188,354 |
489 |
Unknown |
421 |
3,827 |
9.1 |
178,868 |
425 |
|
|
|
|
|
|
Total |
33,570 |
312,112 |
9.3 |
15,353,608 |
457 |
Pharmacotherapy classes of asthma-related medications
Table 7. Pharmacotherapy classes of asthma-related medications among recipients of West Virginia Medicaid who had at least two prescription claims for asthma-related drugs and amounts reimbursed by Medicaid for the same – By demographic category, 2002
Pharmacotherapy class | Number (and %) of recipients with asthma30 (N1) |
Number (and %) of prescription claims31 (N2) |
Total amount reimbursed32 ($) |
Average amount per claim33 ($) |
||
---|---|---|---|---|---|---|
Spacer devices | 1,273 | (3.8%) | 3,291 | (1.1%) | 37,872 | 12 |
Short-acting beta- agonists (all dosage forms) | 26,370 | (78.6%) | 110,758 | (35.5%) | 3,324,310 | 30 |
Oral corticosteroids | 10,058 | (30.0%) | 24,795 | (7.9%) | 218,593 | 9 |
Inhaled corticosteroids | 10,951 | (32.6%) | 33,225 < | (10.6%) | 2,924,536 | 88 |
Ipratropium | 8,469 | (25.2%) | 39,386 | (12.6%) | 2,706,208 | 69 |
Methylxanthines | 3,764 | (11.2%) | 25,987 | (8.3%) | 544,438 | 21 |
Salmeterol | 3,645 | (10.9%) | 13,400 | (4.3%) | 992,797 | 74 |
Leukotriene modifiers | 11,069 | (33.0%) | 55,919 | (17.9%) | 4,189,853 | 75 |
Cromolyn/Nedocromil | 1,489 | (4.4%) | 5,351 | (1.7%) | 415,001 | 78 |
Total | 33,570 | (100%) | 312,112 | (100%) | 15,353,608 | 49 |
Figure 3. Number of prescription claims for asthma-related medications among recipients of West Virginia Medicaid who had at least two prescription claims for asthma-related drugs – By pharmacotherapy class, 200234
Figure 4. Total reimbursements by West Virginia Medicaid for asthma-related prescriptions among recipients who had at least two prescription claims for asthma-related drugs – By pharmacotherapy class, 200235
1 Refer to footnotes on methodology in the respective sections of the brief.
2 Total number of recipients of West Virginia Medicaid who had at least one medical claim with a primary or secondary diagnosis of asthma or at least two prescription claims for an asthma-related medication (at least one of which was for a drug other than an oral steroid).
3 Rates based on the number of recipients of West Virginia Medicaid in fiscal year 2002 in each demographic category (Total N = 356,374).
4 Rates for recipients aged 65 and older are not reliable due to the impact of Medicare penetration in this age group.
5 Total = (Amount reimbursed by West Virginia Medicaid for recipients who had medical services with a primary or secondary diagnosis of asthma, including all asthma-related prescription claims for these recipients) + (Amount reimbursed for recipients who did not have medical services for asthma, but who had at least two prescription claims for an asthma-related medication, at least one of which was for a drug other than an oral steroid).
6 Average amount reimbursed by West Virginia Medicaid for asthma-related medical services and prescription drugs per recipient identified with asthma by demographic category.
7 See Footnotes 2 and 5 on Page 3.
8 See Footnotes 2 and 5 on Page 3.
9 Number of outpatient visits with a primary or secondary diagnosis of asthma among recipients of West Virginia Medicaid.
10 Rates based on the number of outpatient visits with a primary or secondary diagnosis of asthma divided by the number of recipients of West Virginia Medicaid during fiscal year 2002 in each demographic category (Total N = 356,374).
11 Rates for recipients aged 65 and older are not reliable due to the impact of Medicare penetration in this age group.
12 Total amount reimbursed by West Virginia Medicaid for outpatient visits with a primary or secondary diagnosis of asthma.
13 Average amount reimbursed by West Virginia Medicaid per outpatient visit with a primary or secondary diagnosis of asthma.
14 Number of ER visits with a primary or secondary diagnosis of asthma among recipients of West Virginia Medicaid.
15 Rates based on the number of ER visits with a primary or secondary diagnosis of asthma divided by the number of recipients of West Virginia Medicaid during fiscal year 2002 in each demographic category (Total N = 356,374).
16 Rates for recipients aged 65 and older are not reliable due to the impact of Medicare penetration in this age group.
17 Total amount reimbursed by West Virginia Medicaid for ER visits with a primary or secondary diagnosis of asthma.
18 Average amount reimbursed by West Virginia Medicaid per ER visit with a primary or secondary diagnosis of asthma.
19 Number of hospital admissions with a primary or secondary diagnosis of asthma among recipients of West Virginia Medicaid.
20 Rates based on the number of hospital admissions with a primary or secondary diagnosis of asthma divided by the number of recipients of West Virginia Medicaid during fiscal year 2002 in each demographic category (Total N = 356,374).
21 Rates for recipients aged 65 and older are not reliable due to the impact of Medicare penetration in this age group.
22 Total amount reimbursed by West Virginia Medicaid for hospital visits with a primary or secondary diagnosis of asthma.
23 Average amount reimbursed by West Virginia Medicaid per hospital visit with a primary or secondary diagnosis of asthma.
24 Average length of stay per hospital visit with a primary or secondary diagnosis of asthma.
25 Number of recipients of West Virginia Medicaid who had at least two prescription claims for asthma-related medication, at least one of which was for a drug other than an oral steroid.
26 Number of prescription claims for asthma-related medications for each demographic category.
27 Average number of prescription claims for asthma-related medication per recipient in each demographic category.
28 Total amount reimbursed by West Virginia Medicaid for prescriptions for asthma-related medications.
29 Average amount reimbursed by West Virginia Medicaid for asthma-related medications per recipient.
30 Based on recipients with at least two prescription claims for asthma-related medication, at least one of which was for a drug other than an oral steroid.
31 Number of prescription claims in each pharmacotherapeutic category.
32 Total amount reimbursed by West Virginia Medicaid for prescriptions in each pharmacotherapeutic category.
33 Average amount reimbursed by West Virginia Medicaid per claim in each pharmacotherapeutic category.
34 See Footnotes 30 and 31 on Page 9.
35 See Footnotes 30 and 32 on Page 9.
If you have questions concerning the content of this page, please contact Tom Light at (304) 558-9100 or dhhrvitalreg@wv.gov.
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