Pdf predictive performance of comorbidity measures in. Research articlecomparison of different comorbidity measures for use with administrative data in predicting short and longterm mortality yutseng chu 1, yeeyung ng2,3 and shiaochi wu1 abstract background. This study sought to create cci and em lists of read codes, which are standard terminology used in some large primary care databases. Performance of comorbidity measures to predict stroke and. Colon cancer is a disease of older people, many of whom have. Comorbidities are related to an increase in hospital costs, hospital mortality and lengthofstay. Comorbidity measures for use with administrative data meta. Abstract background it is important to find a comorbidity measure with better performance for use with administrative data. Understanding racial disparities in hiv using data from the veterans aging cohort 3site study and va administrative data.
Elixhauser comorbidity software for icd10cm beta version. The or for any antidepressant use, adjusted for age, sex, and calendar year was 1. While mental comorbidity is considered common in multiple sclerosis ms, its impact is poorly defined. Comparative performance of comorbidity measures in.
A comparison of comorbidity measurements to predict. Background hospital reporting systems commonly use administrative data to calculate comorbidity scores in order to provide riskadjustment to outcome indicators. The performance of comorbidity measures for predicting mortality in chronic disease populations and using icd9 diagnosis codes in administrative health data has been investigated in several. Comorbidity administrative data lumbar spine introduction there is increasing interest in the use of admin istrative databases.
Using administrative health data we identified persons with ms and a matched general population cohort. Context patients with cancer often have other medical ailments, referred to as comorbidity. The report includes the technical documentation for the comorbidity software and describes three topics. Elixhauser comorbidity measures for use with administrative data.
Finally, given the increasing availability of realtime administrative data through electronic claims submission, the authors wanted to see if comorbidity measures calculated for a period immediately before an event would better predict stroke and death than the same measures when calculated for a baseline period that was longer but more. After further adjustment for comorbidity measures, the or was 0. Data were drawn from all adult, nonmaternal inpatients from 438 acute care hospitals in california in 1992 n 1,779,167. Comorbidity technical report national cancer institute. In search of the perfect comorbidity measure for use with administrative claims data. The objective of this study was to compare the performance of three comorbidity measures using information from different data. Researchers have also used pharmacy dispensing information to create comorbidity measures, where the use of. Thus the majority of the existing comorbidity measures are atheoretical and consequently limited in their ability to prognosticate and advance science on diagnostic consolidation or common treatment approaches. This study attempts to develop a comprehensive set of comorbidity measures for use with large administrative inpatient datasets. A modification of the elixhauser comorbidity measures into a point system for hospital death using administrative data. Prognostic importance of comorbidity in a hospitalbased. The burden of comorbidity in people with epilepsy is high. Measures for use with administrative data comorbidity.
Articles up to march 18, 2011 were searched based on our predefined terms. Charlson and rxrisk comorbidity indices were predictive. Research articlecomparison of different comorbidity. Optimizing the measurement of comorbidity for a south. Several comorbidity measures including the charlson comorbidity index cci, the elixhauser measure, and the multipurpose australian comorbidity scoring system macss have been developed and adapted for the purpose of casemix adjustment and to control for. Observed association between antidepressant use and. Comorbidity is the coexistence of diseases or disorders in addition to a primary disease of interest.
Pdf comparison of different comorbidity measures for use. Comparison of different comorbidity measures for use with administrative data in predicting short and. The comorbid module calculates the weighted sum of comorbidities, as well as comorbidity scores based on the charlson index, which reflects the cumulative increase in likelihood of oneyear. Optimal look back period and summary method for elixhauser comorbidity measures in a us populationbased electronic health record database. Request pdf comparison of the elixhauser and charlsondeyo methods of comorbidity measurement in administrative data comorbidity.
The elixhauser comorbidity software creates these 29 comorbidity measures. Several mechanisms explain how epilepsy and comorbidities are associated, including shared risk factors and bidirectional relations. Developing and validating a novel multisource comorbidity. Pdf use of comorbidity scores for control of confounding. These programs are applicable to the medical field for calculating measures of comorbidity using administrative data. The conceptualization and measurement of comorbidity. Predictive performance of comorbidity measures in administrative databases for diabetes cohorts. Several directorates within summit use administrative data for their contracts. Optimizing the measurement of comorbidity for a south australian colorectal cancer population using administrative data.
Comorbidity has a detrimental effect on cancer survival, and its effect varies by cancer site 110. We also identified 159 cases of hospitalization for aspiration pneumonia the secondary outcome and 636 controls. Read charlson scores based on icd10 administrative data were valid in assessing comorbidity in patients undergoing urological cancer surgery, journal of clinical epidemiology on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Given the disparate comorbidity measures in use and. A comprehensive set of 30 comorbidity measures was developed. Comparison of different comorbidity measures for use with administrative data. It also aimed to describe and compare the predictive properties of the cci and em. Comorbidity may impact treatment decisionmaking, prognosis, and quality of care assessment.
Calculating measures of comorbidity using administrative data. In search of the perfect comorbidity measure for use with. Calculating measures of comorbidity using administrative data posted on june 27, 2014 by vicki no comments v the development of a stata program to calculate published measures of comorbidity will be of value to researchers working with inpatient discharge data coded in icd9. Several diseases, including depression, anxiety, dementia, migraine, heart disease, peptic ulcers, and arthritis are up to eight times more common in people with epilepsy than in the general population. The performance of comorbidity measures for predicting mortality in chronic disease populations and using icd9 diagnosis codes in administrative health data has been investigated in several studies, but less is known about predictive performance. The validity of the rxrisk comorbidity index using. The elixhauser comorbidity measure was developed using administrative data from a statewide california inpatient database from all nonfederal inpatient community hospital stays in california n 1,779,167. Comorbidity coding trends in hospital administrative databases. Coding algorithms for defining charlson and elixhauser co. Comparison of the elixhauser and charlsondeyo methods of. Further, the existing measures and data sources may have varying levels of sensitivity for specific outcomes. The first software download is the format program that defines a format library needed to.
View abstract van walraven c, austin pc, jennings a, quan h, forster aj. This session will focus on use of va and medicare data to obtain information for comorbidity measurements. Use of comorbidity scores for control of confounding in studies using administrative databases. Applying comorbidity measures using va and medicare data. New morbidity and comorbidity scores based on the structure of the. Objective to assess whether comorbidity information can provide important prognostic information in a hospitalbased cancer registry design, setting, and participants an observational. Comorbidity measures for use with administrative data ovid insights. The second sas program, creation of elixhauser comorbidity variables, applies the formats created above to a data set containing administrative data and then creates the comorbidity variables. Charlson scores based on icd10 administrative data were. Youll understand some of the important issues related to using administrative data to measure comorbidity and also some of the complications involved when we combine va and medicare data to assess comorbidities. Purpose many patients consulting in primary care have multiple conditions multimorbidity. Comorbidity measures for use with administrative data. The downloading information for creating the index weights is. Because research using administrative datasets often examines re source use or clinical outcomes, we developed the comorbidity measures to predict hospital charges.
The elixhauser comorbidity measure developed a list of 30 comorbidities relying on the icd9cm coding manual. The development of a stata program to calculate published measures of comorbidity will be of value to researchers working with inpatient discharge data coded in icd9cm or icd10. Outcome measures were those commonly available in administrative data. Comparison of different comorbidity measures for use with administrative data in predicting short and longterm mortality. The charlson index has also been adapted for use with administrative data containing diagnoses classified by the. We compared 4 previously published comorbidity measures developed for use with administrative data. The models including the weighted rxrisk score or 43 comorbidity measures were better predictors of 1year mortality than any of the crude prescription measures. Full text optimal look back period and summary method.
Abstracted data elements included first and last author discipline, geographic study location, study design, setting, sample size, patient characteristics index condition and age, definition of comorbidity, the data source for the comorbidity data, comorbidity measure used, whether the measure was modified from its original use and if so how. Powered by comorbidity measures for use with administrative data. Comorbidity measures, such as the charlson comorbidity index cci and elixhauser method em, are frequently used for riskadjustment by healthcare researchers. Comparison of different comorbidity measures for use with. List of comorbidities included in the elixhauser comorbidity score.
We validated and applied administrative case definitions for any mental comorbidities in ms. Charlson and rxrisk comorbidity indices were predictive of mortality in the australian health care setting. Do patterns of comorbidity vary by hiv status, age, and. It is important to find a comorbidity measure with better performance for use with administrative data. International consortium for health outcomes measurement. Measures of multimorbidity and morbidity burden for use in.