• Tricia Morphew, Wendy Altamirano, Stanley L Bassin, and Stanley P Galant.
• Morphew Consulting, LLC, 2208 242nd St SW, Bothell, WA 98021. E-mail: tricia@morphewconsulting.com.
• Am J Manag Care. 2017 Apr 1; 23 (4): e120-e126.

ObjectivesAn Asthma Medication Ratio (AMR) of ≥0.50 has gained recognition as a metric related to improved asthma outcomes. The goals of this study were to evaluate asthma outcomes in relation to this threshold in Hispanic children with high-risk asthma and to compare the effectiveness of the Breathmobile (BM) program with usual care (UC), utilizing the AMR-related emergency department utilization (ED) rate.Study DesignHealthcare utilization and prescription claims recorded January 1, 2011, to June 23, 2014, were evaluated pre- versus post year in 164 Medicaid-enrolled children, aged 2 to 18 years, with high-risk persistent asthma (BM group: n = 72; UC group: n = 92).MethodsHigh risk was defined by ≥2 oral corticosteroid fills, or ≥2 ED visits (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 493.0-493.9) or ≥1 IP stay (ICD-9-CM codes 493.0-493.9) in the pre-year. Poisson regression was utilized to compare asthma outcomes pre- versus post year in BM and UC groups and to describe the average number of ED days per 100 patients treated in relation to AMR.ResultsAn AMR of ≥0.50 versus <0.50 was related to 49% fewer ED visits (P <.05). BM proved to be more effective than UC in increasing the percent who achieved an AMR ≥0.50 from a baseline of 47.2% to 80.6% versus 50.0% to 65.2% post year, respectively. This difference was reflected in the significant 52% reduction in average number of ED visits post year for the BM cohort versus 13% for the UC cohort.ConclusionsView achievement of the AMR ≥0.50 as an informative metric in program evaluation and for healthcare organizations to measure the quality of care provided to high-risk patients with asthma.

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