Transcript Physician Asthma Care Education (PACE)

P hysician
A sthma
C are
E ducation
Evaluation Methods
Parental Factors
Provider
Knowledge
Provider
Attitudes
Provider
Behavior
Physician
Factors
Patient Factors
Environment
Factors
Health System
Factors
(non-MD)
P hysician
A sthma
C are
E ducation
Other
Confounders
Patient
Outcomes
Provider Survey
• Measure changes in knowledge, attitudes and
self-reported provider behavior
• Self-administered
• Immediately before and after the seminar
• Pros & Cons:
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Relatively inexpensive
Difficult to maintain high response rate
No patient outcomes
Self-reported behavior
Provider
Knowledge
Provider
Attitudes
P hysician
A sthma
C are
E ducation
Provider
Behavior
Medical Record Audit
• Measure changes in provider behavior
• Requires trained chart reviewers
• Pros & Cons:
– Information regarding physician prescription,
outpatient visits (urgent & non-urgent)
– Poor documentation of asthma counseling, asthma
severity
– Consent may be required from each patient/parent
– Information on outpatient asthma health care
utilization
Parental Factors
Provider
Knowledge
Provider
Attitudes
Provider
Behavior
Physician
Factors
Patient Factors
Environment
Factors
Health System
Factors
(non-MD)
P hysician
A sthma
C are
E ducation
Other
Confounders
Patient
Outcomes
Parent Telephone Survey
• Measure changes in outcomes, self-management
• Requires trained telephone interviewers
• Pros & Cons:
– Information on outpatient asthma health care
utilization, parent perceptions of physician behavior,
asthma severity and asthma control
– Difficult to schedule, high cost
– Consent required from each patient/parent
– May need to confirm medications, actual physician
prescription (versus patient adherence)
Parental Factors
Provider
Knowledge
Provider
Attitudes
Provider
Behavior
Physician
Factors
Patient Factors
Environment
Factors
Health System
Factors
(non-MD)
P hysician
A sthma
C are
E ducation
Other
Confounders
Patient
Outcomes
Claims Data
• Measure changes asthma health care utilization
• Requires trained analyst/programmer
• Pros & Cons:
– Information on outpatient asthma health care utilization
– No clinical information (appropriateness of controller
medications for persistent asthma; determining if ED
visit or hospitalization is due to asthma)
– Difficult to attribute claim to a specific physician
– Multiple patients belong to different MCOs
– No consistent CPT codes for “asthma counseling”
Annual Data Collection
Outcome of Interest
Source
Physician Knowledge
Mailed Surveys
Physician Attitudes
Physician Behavior
Mailed Surveys
Chart Audits
Patient Surveys
Patient Outcomes
Chart Audits
Patient Surveys
P hysician
A sthma
C are
E ducation