Comorbidity Assessment Is Uneven Across Veterans Health Administration and Medicare for the Same Patient
Implications for Risk Adjustment
Bibliographic Data
| ID | 9104921 |
|---|---|
| Authors | Risha Gidwani (0000-0002-3548-2332, VA Palo Alto Health Care System, corresponding author), Risha Gidwani-Marszowski (VA Health Economics Resource Center), Derek Boothroyd (0000-0001-5387-6995, Quantitative Sciences Unit, Department of Medicine, Stanford University School of Medicine), Jacob Needleman (0000-0002-2875-0589), Jack Needleman (Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles), Samantha Illarmo (VA Health Economics Resource Center, corresponding author), Steven M Asch (0000-0001-5838-5335, VA Palo Alto Health Care System) |
| Year | 2020 |
| Volume | 58 |
| Issue | 8 |
| Pages | 717-721 |
| Publication date | 2020-08-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000001329 |
| PMID | 32692137 |
| OpenAlex | W3013208073 |
| Language | EN |
| References cited | 13 |
OBJECTIVE: Compare comorbidity identification in Medicare and Veterans Health Administration (VA) data for the purposes of risk adjustment. DATA SOURCES: Analysis of Medicare and VA datasets for dually-enrolled Veterans receiving care in both settings, fiscal years 2010-2014. STUDY DESIGN: A retrospective analysis of administrative data for a national sample of cancer decedents. DATA EXTRACTION METHODS: Comorbidities were evaluated using Elixhauser and Charlson coding algorithms. PRINCIPAL FINDINGS: Clinical comorbidities were more likely to be recorded in Medicare than in VA datasets. Of 42 comorbidities, 36 (86%) were recorded at a different frequency. For example, congestive heart failure was recorded for 22.0% of patients in Medicare data and for 11.3% of patients in VA data (P<0.001). CONCLUSION: There are large differences in comorbidity assessment across VA and Medicare administrative data for the same patient, posing challenges for risk adjustment
Chronic disease · Comorbidity · Data extraction · Diagnosis code · Environmental health · Family medicine · Health care · MEDLINE · Multiple Chronic Conditions · Retrospective cohort study · Veterans Affairs · Chronic Disease Management Strategies · Emergency Medicine · Internal Medicine · Medical Coding and Health Information · Medicine · Primary Care and Health Outcomes
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| Highly cited | No |
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