Table 1.
Dependent Variables, Denominator, and Rationale
| Variable/Asthma Care Measure |
Variable Type | Denominator | Note |
|---|---|---|---|
| ICD-coded asthma diagnosis among those with suspicious respiratory symptoms | |||
| Prevalence of asthma diagnosis ever | Binary (yes/no) | Entire study sample | Based on ICD9 and ICD10 codes in an encounter or on the problem list |
| Diagnosis of asthma in the presence of symptoms suggestive of asthma | Binary (yes/no) | Those who presented with at least one symptom consistent with asthma, including wheeze, 4 or more visits for cough, bronchitis,30 and documented albuterol prescription | We chose to include albuterol prescription given the common practice of prescribing albuterol for symptom treatment even prior to an official diagnosis of asthma28 |
| Appropriate EHR documentation of asthma and its severity | |||
| Asthma on problem list | Binary (yes/no) | Children with an asthma diagnosis in the study period | Placement of chronic conditions on a “problem list” is a standard of care for chronic conditions and for the use of electronic health records9,31-33 |
| Asthma severity on problem list | Binary (yes/no) | Children with an asthma diagnosis in the study period | Documented asthma severity guides medication choices7,8 |
| Medication prescription | |||
| Albuterol prescription | Binary (yes/no), annual rate | Children with an asthma diagnosis in the study period | Albuterol is a first line prescription choice for most children with asthma7,8 |
| Inhaled corticosteroid prescription | Binary (yes/no) | Children with an asthma diagnosis in the study period and separately, children with a “persistent” (mild, moderate, or severe) asthma diagnosis in the study period | Inhaled corticosteroids are indicated in children with “persistent” asthma diagnoses7,8 |
| Oral corticosteroid prescription | Binary (yes/no) | Children with an asthma diagnosis in the study period and separately, children with a “persistent” (mild, moderate, or severe) asthma diagnosis in the study period | Oral corticosteroids are indicated for asthma exacerbations, and are prescribed during and prior to exacerbations7,8 |
| Yearly influenza vaccination rates | |||
| Influenza vaccination | Immunized in at least 50% of study years yes/no. Immunized in at least 80% of study years (yes/no) | Entire study sample | Given the indications for influenza vaccine in all children, we analyzed differences in our entire population12 |
EHR indicates electronic health record; ICD, International Classification of Disease.