Payer database and geospatial analysis to evaluate practice patterns in treating allergy in North Carolina

• Published in: American journal of otolaryngology Vol. 39; no. 1; pp. 20 - 24
• Main Authors: Crowson, Matthew G., Schulz, Kristine, Ulvila, Alex, Witsell, David L.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2018; Elsevier Limited
• Subjects: Airway management; Allergens; Allergies; Allergy; Asthma; Codes; Cohort Studies; Databases, Factual; Diagnostic systems; Endoscopy; Female; Geographic information systems; Health care access; Health care delivery; Health services; Humans; Hypersensitivity - epidemiology; Hypersensitivity - therapy; Immunology; Immunotherapy; Immunotherapy - methods; Insurance Claim Review; Insurance, Health, Reimbursement - economics; Internal medicine; Male; Medicine; North Carolina; Nose; Otolaryngology; Otolaryngology - standards; Otolaryngology - trends; Outdoor air quality; Patients; Physicians; Practice Patterns, Physicians' - economics; Practice Patterns, Physicians' - trends; Primary care; Public health; Quality of life; Retrospective Studies; Rhinitis, Allergic - diagnosis; Rhinitis, Allergic - epidemiology; Rhinitis, Allergic - immunology; Rhinitis, Allergic - therapy; Software; Spatial analysis; Standard deviation; Statistical analysis; Trends; Variables; Visualization; Otolaryngology; Allergy; Health services; Health care delivery
• ISSN: 0196-0709; 1532-818X; 1532-818X
• DOI: 10.1016/j.amjoto.2017.10.004

The objective of this study was to characterize the delivery of allergy care in North Carolina using a large payer charge database and visualization techniques. Geospatial database analysis. North Carolina State claims database. Medical data from the 2013 FAIR Health National Private Insurance Claims (FH NPIC) database for North Carolina was mined for CPT codes and charges for allergy testing, and for the preparation and provision of allergen immunotherapy. Provider and patient variables were analyzed. Analyses were performed to compare differences in allergy care delivery. A visualization strategy complemented the analytic approach. 162,037 CPT charge entries were analyzed. Allergy-immunology specialists were the most common provider specialty to perform allergy immunotherapy treatments (68.9%, p<0.05). Among other specialties, there were no significant differences between specialists performing immunotherapy when comparing otolaryngology, family practice, and internal medicine (16.3%; 4.6%; 2.6%; p>0.05). Providers with an M.D. degree were the most common provider type. The three most commonly treated diagnoses were allergic rhinitis variants. Females were more likely to receive allergy treatments versus males (55.9% vs. 51.5%; p<0.001), and were more likely to receive allergy testing (65.3% vs. 34.7%: p<0.005). Internal medicine providers charged higher than any other specialist type (p<0.05) for allergy immunotherapy. Using a large payer database coupled with visualization techniques was an efficient approach to characterizing the state-wide provision patterns of allergy diagnostic and therapy services in North Carolina. This first tier approach to efficiently exploring questions and describing populations is valuable.