Identifying Increased Risk of Readmission and In-hospital Mortality Using Hospital Administrative Data: The AHRQ Elixhauser Comorbidity Index

Medical Care
Brian J MooreAnne Elixhauser

Abstract

We extend the literature on comorbidity measurement by developing 2 indices, based on the Elixhauser Comorbidity measures, designed to predict 2 frequently reported health outcomes: in-hospital mortality and 30-day readmission in administrative data. The Elixhauser measures are commonly used in research as an adjustment factor to control for severity of illness. We used a large analysis file built from all-payer hospital administrative data in the Healthcare Cost and Utilization Project State Inpatient Databases from 18 states in 2011 and 2012. The final models were derived with bootstrapped replications of backward stepwise logistic regressions on each outcome. Odds ratios and index weights were generated for each Elixhauser comorbidity to create a single index score per record for mortality and readmissions. Model validation was conducted with c-statistics. Our index scores performed as well as using all 29 Elixhauser comorbidity variables separately. The c-statistic for our index scores without inclusion of other covariates was 0.777 (95% confidence interval, 0.776-0.778) for the mortality index and 0.634 (95% confidence interval, 0.633-0.634) for the readmissions index. The indices were stable across multiple subsamples def...Continue Reading

References

Jun 1, 1992·Journal of Clinical Epidemiology·R A DeyoM A Ciol
Mar 1, 1996·Journal of Clinical Epidemiology·W A GhaliM A Moskowitz
Feb 7, 1998·Medical Care·A ElixhauserR M Coffey
Oct 18, 2000·International Journal of Epidemiology·S Schneeweiss, M Maclure
May 4, 2004·Statistics in Medicine·Lisa M SullivanRalph B D'Agostino
Nov 5, 2008·Proceedings·Marc D SilversteinZiad Haydar
Oct 15, 2010·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Nazima AllaudeenAndrew Auerbach
Feb 11, 2012·Current Opinion in Critical Care·Holly E Hinson, Kevin N Sheth
Aug 30, 2012·Medical Care·Mansour T A SharabianiAlex Bottle
May 29, 2014·Clinical Orthopaedics and Related Research·Mariano E MenendezDavid Ring
Mar 15, 2015·Medical Care·Nicolas R ThompsonSandra D Griffith

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Apr 26, 2019·Journal of the American Heart Association·Yusuke MoritaMoriaki Inoko
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Oct 28, 2018·BMJ Quality & Safety·Skerdi HaviariAntoine Duclos
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Aug 9, 2019·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Craig I ColemanWilliam L Baker
Jul 28, 2019·Journal of Thrombosis and Haemostasis : JTH·Allyson M PishkoAdam Cuker
Aug 23, 2019·European Heart Journal. Quality of Care & Clinical Outcomes·Adrian V HernandezCraig I Coleman
Aug 30, 2019·Journal of the American Geriatrics Society·Christine D JonesJennifer Stevens-Lapsley
Sep 14, 2019·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Xiao XuVrunda B Desai
Oct 10, 2019·The Journal of Bone and Joint Surgery. American Volume·Robert H AseltineCourtland G Lewis
Dec 19, 2019·Stroke; a Journal of Cerebral Circulation·Tyler S ColeAndrew F Ducruet
Jan 22, 2020·Journal of the American Heart Association·Avirup GuhaDaniel Addison
Jan 30, 2020·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Visith UyMichael K Ong
Feb 11, 2020·Journal of General Internal Medicine·Jonathan D BaghdadiRobert Brook
Aug 30, 2019·Surgical Infections·Joseph D ForresterKristan Staudenmayer
Dec 18, 2019·Journal of the National Cancer Institute·Vikram JairamHenry S Park
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