Development of a comorbidity index using physician claims data
Development of a comorbidity index using physician claims data
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DOI：
10.1016/s0895-4356(00)00256-0
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发表时间：
2000-12-01
影响因子：
7.2
通讯作者：
Warren, JL
中科院分区：
文献类型：
--
作者：
Klabunde, CN;Potosky, AL;Warren, JL
当仅考虑住院治疗时，在管理数据集中记录在门诊索赔中的重要合并症可能会在分析中遗漏。利用Charlson及其同事确定的合并症，我们开发了一个合并症指数，该指数包含了医疗保险医生（B部分）索赔中包含的诊断和程序数据。在这项研究中评估的老年前列腺癌（n = 28，868）和乳腺癌（n = 14，943）患者的国家队列中，当仅检查Medicare医院（A部分）索赔时，不到10%的患者患有共病。通过纳入医生索赔，合并症患者的比例增加到25%。新的医生声称，合并症指数对两个患者队列的2年非癌症死亡率和治疗模型有显著贡献。我们证明了一个疾病特异性指数的效用使用另一种方法的建设采用研究特定的权重。医生索赔指数可以与来自住院医院索赔的合并症指数结合使用，或作为一个独立的措施。(C)2000 Elsevier Science Inc. All rights reserved.
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. (C) 2000 Elsevier Science Inc. All rights reserved.