Is patient assessment of asthma care delivery associated with publicly reported performance measures?

Abstract

Objective: To determine the association between patient assessment of healthcare delivery and publicly reported asthma performance measures. Methods: We identified individuals 5–50 years old who had asthma quality measures reported to the Minnesota Community Measurement© (MCM©) by their clinic and sent them a postal survey which included within it the Patient Assessment of Chronic Illness care (PACIC), a validated measure of patient perception of the quality of healthcare delivery. We performed a multivariable analysis to examine the association between PACIC scores and achievement of asthma care quality measures. Results: The response rate for the ACS was 102/367 (28%); a non-response bias analysis revealed no differences between responders and non-responders for age, gender and asthma control. Most responders (73%) reported taking asthma medications daily and most (71%) had poorly controlled asthma. The PACIC score was not associated with any of the asthma quality measures based on the data reported to MCM© by the clinic. A higher PACIC score was, however, associated with having an asthma action plan based on patient-reported data in the ACS (p < 0.0001) but not with patient-reported asthma control or emergency department/hospitalizations for asthma. Conclusions: Patient assessment of high quality asthma care delivery was associated with patient self-report of having an asthma action plan but was not associated with any of the publicly reported asthma performance measures.

• Asthma
• asthma action plan
• delivery of healthcare
• health services research
• outcome and process assessment (healthcare)
• outcome assessment (healthcare)
• quality of healthcare
• quality assurance (healthcare)

Acknowledgements

We thank the following individuals who provided feedback during the Asthma Care Survey development: Marlis O’Brien RRT, Katie Clubb MD, Jim Deming MD and Jerry Volcheck MD. We thank several patients for feedback on the Asthma Care Survey. We thank Ms. Vicki Courson for assistance with obtaining data. Finally, we thank Dr Lawrence Fisher, Dr Lisa Chew and Dr Elizabeth Juniper for permission to use or adapt previously developed survey items.