Abstract
To compare the association of two comorbidity indices, Charlson Comorbidity Index (CCI), and HRQL Comorbidity Index (HRQL-CI), with measures of healthcare resource utilization (HCRU) and work limitations among a large sample of working adults. These indices are calculated based on the number and severity of comorbid conditions. The CCI was developed to predict mortality. The HRQL-CI uses a bi-dimensional algorithm (HRQL-CI Physical; HRQL-CI Mental) to predict SF-12v2 Health Survey physical and mental component summary scores (PCS; MCS), while a revised unidimensional algorithm was developed using the SF-6D. Data [N=17,773] came from the Medical Expenditure Panel Survey (MEPS), a study representative of U.S. households with 5-rounds of interviews across 2 years. HCRU variables were total medical expenditures (MEx), number of medical events (MEv), number of lost work/housework days, and cognitive limitations (Yes/No), reported over round 5 (in year 2) of the study. Comorbidity indices were captured through conditions from year 2. Spearman correlations (rs) were used to assess the association between CCI, HRQL-CI, HRQL-CI Physical, HRQL-CI Mental and each outcome, except for cognitive limitations, for which the generalized coefficient of determination (was used. MEx and MEv were both most strongly associated with HRQL-CI-Physical (rs = 0.40, 0.49, respectively), followed by the unidimensional HRQL-CI (rs = 0.38). Number of lost work days and cognitive limitations were both most strongly associated with the unidimensional HRQL-CI (rs = 0.18, = 0.12), followed by the HRQL-CI Mental (rs = 0.16, = 0.11). All four outcomes were more strongly associated with indices based on HRQL than a commonly-used index based on mortality. While the HRQL-CI Physical was more strongly associated with HCRU, the HRQL-CI Mental was more strongly associated with work limitations. Indices that take into account the effect of comorbid conditions on HRQL should be considered when predicting patient outcomes.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have