Fragmented care in asthma: Data from the French national claims database

Background: Asthma management is a major public health issue. Little is known about the frequency of fragmented care in asthma patients. It is also unclear whether those patients induce higher levels of medical resource utilisation (MRU). Objectives: To determine the proportion of asthma patients being prescribed asthma therapy by ≥ 2 different general practitioners (GPs), and the medical resource utilisation (MRU) induced by these patients. Methods: A random sample of patients aged 16-40, with at least 3 reimbursements of respiratory drugs (R03, ATC classification) was identified in the French national claims database (EGB). Among them, those with at least 2 visits with prescriptions for respiratory drugs in 2007 were selected. Fragmented medical care in 2007 was defined as receiving prescription for respiratory drugs from ≥ 2 different GPs. Patients9 MRU was studied according to the number of distinct GPs prescribing respiratory drugs in 2007. Results: Among 1,009 patients (mean age = 32 year-old, 59% females), nearly 55% of patients received their respiratory therapy from ≥ 2 different GPs (2: 36%, 3: 13% >3: 6%). A salient increase in the dispensing of short-acting beta agonists in 2007 was observed with the level of fragmented care in 2007 (p Conclusions: Our data suggest that fragmented asthma care is not exceptional and may result in higher unscheduled MRU. The reasons of fragmented care require a better understanding to optimise the quality of care in asthma.