The Quality of Asthma Care Among Adults With Substance-Related Disorders and Adults With Mental Illness
Psychiatr Serv 60:43-49, January 2009


The purpose of this study was to investigate whether the presence of substance-related disorders or mental illness may affect the quality of medication management in asthma care.

Odds of achieving the HEDIS measure were lower for patients with substance-related or schizophrenia disorders in two states (range of odds ratio [OR]=.69, 95% confidence interval [CI]=.53–.90, to OR=.81, 95% CI=.69–.96), but the odds increased for patients with depressive disorders in two states (OR=1.34, CI= 1.12–1.61; OR=1.37, CI=1.05–1.77) and for patients with bipolar disorder in one state (OR=1.69, CI=1.13–2.55). Odds of achieving the ratio measure were lower for patients with substance-related disorders in four states (range of OR=.63, CI=.47–.88, to OR=.75, CI=.62–.92) and higher for patients with depressive disorders, although only in one state (OR=1.25, CI=1.03–1.53).

Patients with substance-related disorders and those with schizophrenia disorders may be receiving lower-quality asthma care, whereas patients with some other forms of mental illness may be receiving higher-quality care. Further studies are needed to identify the determinants of high-quality asthma care and the validity of quality measures based on administrative data in these populations.

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