About Child Health Plus Data

Asthma Child Health Plus (CHP) information was obtained from the New York State (NYS) Department of Health, Office of Health Insurance Programs Data Mart. CHP is a NYS program that provides health coverage to uninsured children up to the age of 19.

CHP enrollees have access to preventive and primary care, inpatient care, eye care, as well as additional health services. Information obtained from program-based surveillance is not representative of the general population, since only a small proportion of the NYS population is served by Child Health Plus programs. However, these data provide useful information about those who have asthma, including the burden of asthma and the use of health care services and medications prescribed for this population.

About Asthma Prevalence for the Child Health Plus Population

Asthma prevalence among the Child Health Plus (CHP) population is calculated for two different asthma groups:

  1. CHP enrollees in the asthma universe population
  2. CHP enrollees in the persistent asthma population

Definitions for the asthma universe and persistent asthma groups are based on the technical specifications established by the National Committee for Quality Assurance for the Healthcare Effectiveness Data and Information Set (HEDIS®) 2011.

Asthma Universe: Individuals are identified as being in the asthma universe of patients if they had at least:

  • One outpatient visit with asthma (ICD-9 code 493.XX) as one of the listed diagnoses during a specified 12-month period; or
  • One emergency department (ED) visit with asthma (ICD-9 code 493.XX) as the principal diagnosis during a specified 12-month period; or
  • One acute inpatient discharge with asthma (ICD-9 code 493.XX) as the principal diagnosis during a specified 12-month period; or
  • Four asthma medication dispensing events * (i.e., an asthma medication was dispensed on four occasions) during a specified 12-month period.

Persistent Asthma: Individuals are identified as persistent asthma patients if they met at least one of the criteria below during both 2009 and 2010 (criteria need not be the same across years):

  • Four outpatient visits with asthma (ICD-9 code 493.XX) as one of the listed diagnoses and at least two asthma medication dispensing events during a specified 12-month period; or
  • One ED visit with asthma (ICD-9 code 493.XX) as the principal diagnosis during a specified 12-month period; or
  • One acute inpatient discharge with asthma (ICD-9 code 493.XX) as the principal diagnosis during a specified 12-month period; or
  • Four asthma medication dispensing events * (i.e., an asthma medication was dispensed on four occasions) during a specified 12-month period.

Asthma universe and persistent asthma prevalence rates for the CHP population (aged 0 to 18 years) are presented for the total population and stratified by age group, gender, race and ethnicity, county of residence, and geographic region (New York City and Rest of State).

Asthma universe prevalence rates were generated for individuals aged 0 to 18 years who were continuously enrolled in CHP for 12 or more months as of December of 2010.

Persistent asthma prevalence was generated for individuals aged 0 to 18 years who were continuously enrolled in CHP for 24 or more months, as of December 2010.

* A dispensing event is one prescription of an amount lasting 30 days or less; multiple inhalers of the same medication filled on the same date of service should be counted as one dispensing event. There is also a restriction regarding leukotriene dispensing events: for an individual identified as an asthma universe or persistent asthma because of at least four asthma medication dispensing events, and leukotriene modifiers were the sole asthma medication dispensed, the member must meet any one of the other three criteria for inclusion in the asthma universe or persistent asthma population, or have at least one diagnosis of asthma in any setting.

About Asthma-Related Utilization of Health Services for the Child Health Plus Population

Health service utilization data were generated for New York State (NYS) residents enrolled in the Child Health Plus (CHP) program.

Health service utilization data were generated for NYS CHP enrollees in the asthma universe population, aged 0 to 18 years, who were continuously enrolled in CHP for 12 or more months as of December 2010.

Encounter (i.e., face-to-face) records were considered to be asthma-related if they had a primary diagnosis code of asthma (International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9 CM) code of 493.XX). Asthma-related pharmacy dispensing events were identified using the National Drug Codes specified in the Healthcare Effectiveness Data and Information Set (HEDIS®) 2011 guidelines indicative of asthma.

For the purpose of these health utilization analyses, services were divided into inpatient, emergency department, outpatient, and pharmacy services. A hierarchical approach was taken to categorize the services. All inpatient records were identified first, followed by emergency department services, pharmacy records and finally outpatient services. Because all records that were not identified as inpatient, emergency room, or pharmacy were considered as outpatient services, this category may contain additional areas besides physician and clinic services.

The number and rate of these services and dispensing events per 100 asthma universe population is provided. Results are presented for the total population and stratified by age group, gender, race and ethnicity, and geographic region (New York City and Rest of State).