These maps provide summary data for Chicago Medicaid recipients diagnosed with asthma using data provided by the Illinois department of Public Aid Bureau of Budget and Analysis to the Chicago Asthma Consortium. The data presented covers Fiscal Year 1999 (July 1998 to June 1999) and includes Medicaid recipients who had at least one inpatient or outpatient asthma visit from July of 1995 to June 1999. All of the analyses described below were performed at the individual level using coded recipient numbers to protect confidentiality. Using the results of these analyses the results were then grouped by recipient zip code to produce the maps. The data is presented both graphically as a color-coded map and in tabular format, which is available by clicking on the zip code of interest. Major street boundaries are provided for each of the zip codes.

Percentage of Chicago Medicaid recipients with appropriate inhaled steroid use

This map displays the percentage of Medicaid recipients with appropriate use of inhaled steroid therapy as defined by NHLBI guidelines. According to these guidelines, patients with daily use of inhaled beta-agonists (moderate persistent disease) should also be receiving inhaled steroids. This analysis looked at the number of beta-agonist and inhaled steroid prescriptions filled in a 1-year period (July 1998 to June 1999) by each recipient. A recipient was judged to have at least daily use of beta-agonists during that year if three or more prescriptions for beta-agonists were filled. If less than three canisters of inhaled steroids were filled by that same individual, their inhaled steroid therapy was judged to be sub-optimal. Patients not requiring daily inhaled beta agonists (less than three beta agonist canisters filled per year) may not need inhaled steroid therapy and were judged (for the purpose of this analysis) as receiving adequate inhaled steroid therapy. The data was then grouped by the percentage of recipients ages 3- 17 (children) or ages 18 –64 (adults) residing in each zip code who met these criteria.

Percentage of Medicaid Recipients with Regular Outpatient Visits

NHLBI guidelines suggest regular follow up for patients with asthma. It is recommended that even patients with mild-persistent asthma should be seen at least every six months. This analysis was undertaken to determine the proportion of patients who were receiving care as an outpatient rather than in the Emergency Department or Hospital setting. This analysis did not attempt to distinguish patients who were seen on a routine as opposed to an emergent basis in a doctors office. Patients with two or more office visits per year, regardless of diagnosis (as asthma care may be occurring in visits where a different diagnosis was given) were considered to have regular visits. The data is presented as the percentage of patients with regular provider follow-up in each zip code for recipients ages 3-17 or ages 18-64.

Hospitalization rate of Medicaid Recipients by Zip Code

Hospitalization is one of the outcome measures commonly followed for asthma. This analysis looked at the hospitalization rate (number of hospital admissions/year per 1000 asthma recipients) within each zip code for Medicaid recipients. The denominator used was the number of Medicaid patients diagnosed with asthma, as this was the “at risk” population being observed. With this number, rather than the population within a given zip code being used, the observed rates may be higher than reported for the general population. As this database contained only admissions for Medicaid recipients, we did not feel it was appropriate to use the numbers for the general population. As with the other maps the data is grouped by the zip code of residence and by pediatric or adult age groups.