Physician

Asthma
Care Evaluation Methods
Education
 Parental Factors

Provider Provider Provider Physician

Knowledge Attitudes Behavior Factors

Patient Factors
Patient
Outcomes
Environment
Factors

Health System
Factors
(non-MD)

Physician Other
Asthma Confounders

Care
Education
 Provider Survey
• Measure changes in knowledge, attitudes and self-reported
provider behavior
• Self-administered
• Immediately before and after the seminar
• Pros & Cons:
– Relatively inexpensive
– Difficult to maintain high response rate
– No patient outcomes
– Self-reported behavior
 Provider Provider Provider
Knowledge Attitudes Behavior

Physician
Asthma
Care
Education
 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 Provider Provider Physician

Knowledge Attitudes Behavior Factors

Patient Factors
Patient
Outcomes
Environment
Factors

Health System
Factors
(non-MD)

Physician Other
Asthma Confounders

Care
Education
 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 Provider Provider Physician

Knowledge Attitudes Behavior Factors

Patient Factors
Patient
Outcomes
Environment
Factors

Health System
Factors
(non-MD)

Physician Other
Asthma Confounders

Care
Education
 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 Mailed Surveys
Physician Behavior Chart Audits
Patient Surveys
Patient Outcomes Chart Audits
Patient Surveys
Physician
Asthma
Care
Education