A Survey of Asthma Care in Managed Care Organizations: Materials and Methods

Overview of Study Design
A cross-sectional study of asthma care products and services in the managed care environment was conducted, using a selfadministered survey mailed to the medical directors of the MCOs in the Chicago area. The survey was administered between December 1997 and February 1998.
Survey Instrument
Because of a lack of existing instruments specific to managed care, a new self-administered survey instrument was constructed for the purposes of this study. Two senior medical administrators of Chicago-area MCOs served as consultants to inform the initial content of the survey. Once a draft of the survey was complete, it was circulated to several local MCO medical directors for review and comment. The survey underwent two subsequent revisions on the basis of the feedback of the reviewers and consultants.
The final survey instrument contained 84 items in the following content areas: general characteristics of the MCOs, asthma-related services, monitoring of asthma care, and asthma-related quality improvement efforts. Because many MCOs offer more than one type of health plan, the medical directors were asked to respond separately for staff model capitated plans, nonstaff model capitated plans, and noncapitated plans. comments

Study Population
Twenty MCOs were initially identified from a list provided by the Illinois Association of Managed Care Organizations. Eighteen of these MCOs were either staff model health maintenance organizations or had nonstaff model capitated care network products or services; one health plan provided only noncaptitated care. One health plan no longer served the Chicago area at the time of the survey and was therefore considered ineligible.
Survey Administration
In December 1997, the survey, along with a cover letter and postage-paid return envelope, was mailed to the medical directors of the Chicago-area MCOs. The medical directors were requested to return their surveys by mail or fax. Telephone follow-up was conducted, and the potential respondents were notified that they would be given early access to a report of the findings to encourage completion of the survey. Survey administration ended in February 1998.