• Harold J Farber, Edwin A Silveira, Robert Moore, and Marianna M Sockrider.
• Pulmonary Medicine Service, Texas Children's Hospital, 6701 Fannin St, Suite 1040.00, Houston, TX 77030. Email: hjfarber@texaschildrens.org.
• Am J Manag Care. 2022 Jun 1; 28 (6): 254-260.

ObjectivesIdentification of patients with asthma at increased risk for hospitalization and emergency department (ED) visits presents opportunity for intervention.Study DesignRetrospective analysis of computerized health plan claims data.MethodsTexas Children's Health Plan, a large Medicaid managed care program, developed an asthma risk scoring algorithm using the clinically relevant parameters of hospitalization for asthma, ED visits for asthma, short-acting β agonist medication dispensing, inhaled corticosteroid medication dispensing, number of prescribing providers, loss to follow-up, and oral corticosteroid dispensing. The risk score performance was evaluated using 2016-2018 risk scores to predict 2017-2019 asthma hospitalizations and ED visits.ResultsWe identified 107,811 unique members aged 1 to less than 18 years with an asthma diagnosis. For those aged 3 to less than 18 years, the area under the receiver operating characteristic curve (AUC) for risk score predicting hospitalization ranged from 0.72 to 0.79. For those aged 1 to less than 3 years, the AUC ranged from 0.65 to 0.69. Those with a risk score of 1 or greater accounted for 20% to 23% of pediatric members 3 to less than 18 years with asthma but 53% to 56% of asthma hospitalizations in the follow-up year. Sixteen to eighteen percent of those aged 3 to less than 18 years with a risk score of 9 or greater were hospitalized in the follow-up year.ConclusionsTexas Children's Health Plan asthma risk score stratifies risk of asthma hospitalization and ED visits for Medicaid-insured children. The risk score performs better for children aged 3 to less than 18 years than for those aged 1 to less than 3 years.

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