RT Journal Article
SR Electronic
T1 Fragmented care in asthma: Data from the French national claims database
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p4127
VO 38
IS Suppl 55
A1 Laurent Laforest
A1 Jennifer Martin
A1 Idlir Licaj
A1 Gilles Devouassoux
A1 Gerard Chatte
A1 Melanie Broquet
A1 Eric Van Ganse
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p4127.abstract
AB Background: Asthma management is a major public health issue. Little is known about the frequency of fragmented care in asthma patients. It is also unclear whether those patients induce higher levels of medical resource utilisation (MRU).Objectives: To determine the proportion of asthma patients being prescribed asthma therapy by ≥ 2 different general practitioners (GPs), and the medical resource utilisation (MRU) induced by these patients.Methods: A random sample of patients aged 16-40, with at least 3 reimbursements of respiratory drugs (R03, ATC classification) was identified in the French national claims database (EGB). Among them, those with at least 2 visits with prescriptions for respiratory drugs in 2007 were selected. Fragmented medical care in 2007 was defined as receiving prescription for respiratory drugs from ≥ 2 different GPs. Patients' MRU was studied according to the number of distinct GPs prescribing respiratory drugs in 2007.Results: Among 1,009 patients (mean age = 32 year-old, 59% females), nearly 55% of patients received their respiratory therapy from ≥ 2 different GPs (2: 36%, 3: 13% >3: 6%). A salient increase in the dispensing of short-acting beta agonists in 2007 was observed with the level of fragmented care in 2007 (p<0.001). Likewise, fragmented care was associated with free-access-to-care status (p<0.01), more asthma-related admissions (p<0.01) and medical visits in 2007 (p<0.001). Conversely, no major association was observed as to patients' age and gender.Conclusions: Our data suggest that fragmented asthma care is not exceptional and may result in higher unscheduled MRU. The reasons of fragmented care require a better understanding to optimise the quality of care in asthma.