The DOI matches its Crossref record; 3 of the 3 references it cites were found in a registry or an index.
Identifying Increased Risk of Readmission and In-hospital Mortality Using Hospital Administrative Data: The AHRQ Elixhauser Comorbidity Index
Abstract
Objective: 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. Data Sources: 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. Methods: 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. Results: 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 defined by demographic characteristics or clinical condition. The addition of other commonly used covariates (age, sex, expected payer) improved discrimination modestly. Conclusions: These indices are effective methods to incorporate the influence of comorbid conditions in models designed to assess the risk of in-hospital mortality and readmission using administrative data with limited clinical information, especially when small samples sizes are an issue.
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Cites
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Cited by
Rhee, C., Kadri, S. S., Dekker, J. P., Danner, R. L., Chen, H.-C., Fram, D., Zhang, F., Wang, R., Klompas, M., & Program, F. T. C. P. E. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.2899 · Cited by 397
comorbidity: An R package for computing comorbidity scores
Gasparini, A. (2018) · Journal of Open Source Software · doi:10.21105/joss.00648 · Cited by 361
Yehia, B. R., Winegar, A., Fogel, R., Fakih, M., Ottenbacher, A., Jesser, C., Bufalino, A., Huang, R.-H., & Cacchione, J. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.18039 · Cited by 298
Rhee, C., Wang, R., Zhang, Z., Fram, D., Kadri, S. S., & Klompas, M. (2019) · Critical Care Medicine · doi:10.1097/ccm.0000000000003817 · Cited by 122
Immune checkpoint inhibitors and risk of type 1 diabetes
Chen, X., Affinati, A. H., Lee, Y., Turcu, A. F., Henry, N. L., Schiopu, E., Qin, A., Othus, M., Clauw, D., Ramnath, N., et al. (2022) · Diabetes Care · doi:10.2337/dc21-2213 · Cited by 93
Metadata
- Authors
- Moore, B. J., White, S., Washington, R., Coenen, N., & Elixhauser, A.
- Venue
- Medical Care
- Published
- 2017-07
- Volume
- 55
- Issue
- 7
- Pages
- 698-705
- ISSN
- 0025-7079 (ISSN-L)
- OpenAlex
- W2612251907
- Cited by
- 827
- References
- 3
- FWCI
- 35.61
- Type
- journal article
- Language
- en
- Open access
- closed
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- Moore, B. J., White, S., Washington, R., Coenen, N., & Elixhauser, A. (2017). Identifying Increased Risk of Readmission and In-hospital Mortality Using Hospital Administrative Data: The AHRQ Elixhauser Comorbidity Index. Medical Care. https://doi.org/10.1097/mlr.0000000000000735
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