Feb 7, 1998

Comorbidity measures for use with administrative data

Medical Care
A ElixhauserR M Coffey

Abstract

This study attempts to develop a comprehensive set of comorbidity measures for use with large administrative inpatient datasets. The study involved clinical and empirical review of comorbidity measures, development of a framework that attempts to segregate comorbidities from other aspects of the patient's condition, development of a comorbidity algorithm, and testing on heterogeneous and homogeneous patient groups. Data were drawn from all adult, nonmaternal inpatients from 438 acute care hospitals in California in 1992 (n = 1,779,167). Outcome measures were those commonly available in administrative data: length of stay, hospital charges, and in-hospital death. A comprehensive set of 30 comorbidity measures was developed. The comorbidities were associated with substantial increases in length of stay, hospital charges, and mortality both for heterogeneous and homogeneous disease groups. Several comorbidities are described that are important predictors of outcomes, yet commonly are not measured. These include mental disorders, drug and alcohol abuse, obesity, coagulopathy, weight loss, and fluid and electrolyte disorders. The comorbidities had independent effects on outcomes and probably should not be simplified as an index beca...Continue Reading

Mentioned in this Paper

Disseminated Intravascular Coagulation
Action Research
Hospital Mortality
Blood Coagulation Disorders
Outcome and Process Assessment (Health Care)
Water-Electrolyte Imbalance
Data Interpretation, Statistical
Mental Disorders
Not Measured Tumor Identification
Comorbidity

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