Asthma remains one of the key causes of morbidity in children. In response, the Pediatric Asthma Care Port II study was conducted to test the cost-effectiveness of national asthma care guidelines as implemented via two alternative methods. The purpose of this 18-month continuation study is to enhance our understanding of the performance characteristics of outcomes measures for the study of asthma care for children and to translate the implications of the cost-effectiveness analysis. To do so, our team will conduct a number of specific analyses that will both build upon the unique strengths of the existing PAC-PORT data and upon the established health plan relationships that participated in implementing PAC-PORT, The specific aims to be addressed in this continuation study are: 1. To test the ability of pharmacy measures of prescription use (APM) to differentiate individuals according to their future risk for adverse asthma events. 2. TO determine if performance measures based on data extracted from automated medical record databases (including pharmacy, utilization and basic demographics) are valid for physician/ practice profiling of asthma care. 3. To provide efficient design and analysis tools for use in studies involving asthma symptom day count outcomes, and to illustrate the performance of these tools in the PAC PORT II clinical trial 4. To characterize and compare agreement between caregiver reported medical care utilization data and automated claims/ records-based resource use data for cost estimation and cost-effectiveness analyses for children with asthma. 5. To develop a budget impact model for assessing the feasibility of PAC PORT interventions in clinical practice by adapting the results of the cost-effectiveness analysis to address healthcare business concerns.
