Development of a comorbidity index using physician claims data

Important comorbidities recorded on outpatient claims in administrative datasets may be missed in analyses when only inpatient care is considered. Using the comorbid conditions identified by Charlson and colleagues, we developed a comorbidity index that incorporates the diagnostic and procedure data...

Full description

Saved in:
Bibliographic Details
Published in:Journal of clinical epidemiology 2000-12, Vol.53 (12), p.1258-1267
Main Authors: Klabunde, Carrie N, Potosky, Arnold L, Legler, Julie M, Warren, Joan L
Format: Article
Language:English
Subjects:
Administrative data
Biological and medical sciences
Breast cancer
Breast Neoplasms - epidemiology
Claims data
Cohort Studies
Comorbidity
Diagnosis-Related Groups - classification
Epidemiology
Female
General aspects
Humans
Insurance Claim Review
Insurance, Physician Services - statistics & numerical data
Male
Medical sciences
Medicare
Medicare - statistics & numerical data
Methodology
Predictive Value of Tests
Prevalence
Proportional Hazards Models
Prostate cancer
Prostatic Neoplasms - epidemiology
Public health. Hygiene
Public health. Hygiene-occupational medicine
United States - epidemiology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Important comorbidities recorded on outpatient claims in administrative datasets may be missed in analyses when only inpatient care is considered. Using the comorbid conditions identified by Charlson and colleagues, we developed a comorbidity index that incorporates the diagnostic and procedure data contained in Medicare physician (Part B) claims. In the national cohorts of elderly prostate (n = 28,868) and breast cancer (n = 14,943) patients assessed in this study, less than 10% of patients had comorbid conditions identified when only Medicare hospital (Part A) claims were examined. By incorporating physician claims, the proportion of patients with comorbid conditions increased to 25%. The new physician claims comorbidity index significantly contributes to models of 2-year noncancer mortality and treatment received in both patient cohorts. We demonstrate the utility of a disease-specific index using an alternative method of construction employing study-specific weights. The physician claims index can be used in conjunction with a comorbidity index derived from inpatient hospital claims, or employed as a stand-alone measure.
ISSN:0895-4356
1878-5921
DOI:10.1016/S0895-4356(00)00256-0