ArticleJournal of the American Geriatrics Society2013
When comorbidity, aging, and complexity of primary care meet: development and validation of the Geriatric CompleXity of Care Index.
Article in Journal of the American Geriatrics Society, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Measuring multimorbidity beyond counting diseases: systematic review of community and population studies and guide to index choice.BMJ (Clinical research ed.) · 2020Pooled it
- A Systematic Review of Conceptual Frameworks of Medical Complexity and New Model Development.Journal of general internal medicine · 2016Pooled it
- Pilot study on the use of a multimorbidity index in patients receiving home parenteral nutrition.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2026Article
- Artificial intelligence-driven multi-omics approaches in Alzheimer's disease: Progress, challenges, and future directions.Acta pharmaceutica Sinica. B · 2025Review
- Craniocervical trauma above the age of 90: are current prognostic scores sufficient?Neurosurgical review · 2020Article
- Primary care service use by end-of-life cancer patients: a nationwide population-based cohort study in the United Kingdom.BMC family practice · 2020Article
- Measurement of Fall Injury With Health Care System Data and Assessment of Inclusiveness and Validity of Measurement Models.JAMA network open · 2019Article
- Factors Associated With Loss of Usual Source of Care Among Older Adults.Annals of family medicine · 2018Article
- Diabetes care improvement in pharmacist- versus nurse-supported patient-centered medical homes.The American journal of managed care · 2017Article
- Quality of Care Delivered Before vs After a Quality-Improvement Intervention for Acute Geriatric Trauma.Journal of the American College of Surgeons · 2015Observational
- Medication use in community-residing older adults in Taiwan: a comparison between conventional and complementary and alternative medications.Journal of community health · 2015Article
- Contrasting effects of geriatric versus general medical multimorbidity on quality of ambulatory care.Journal of the American Geriatrics Society · 2014Observational
- Abbreviated care-process quality indicator sets linked with survival and functional status benefit in older adults under ambulatory care.Journal of the American Geriatrics Society · 2014Observational
- Comorbidity and prognostic indices do not improve the 5-year mortality prediction of components of comprehensive geriatric assessment in hospitalized older patients.BMC geriatrics · 2014Observational
- Reimagining Day Rehabilitation For Frailty and Neurodegenerative Conditions through the integrated Rehabilitation and EnAblement Program (iREAP).International journal of integrated careArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
objectivesTo develop and validate the Geriatric CompleXity of Care Index (GXI), a comorbidity index of medical, geriatric, and psychosocial conditions that addresses disease severity and intensity of ambulatory care for older adults with chronic conditions.
designDEVELOPMENT phase: variable selection and rating by clinician panel. VALIDATION phase: medical record review and secondary data analysis.
settingAssessing the Care of Vulnerable Elders-2 study.
participantsSix hundred forty-four older (≥75) individuals receiving ambulatory care. MEASURES: DEVELOPMENT: 32 conditions categorized according to severity, resulting in 117 GXI variables. A panel of clinicians rated each GXI variable with respect to the added difficulty of providing primary care for an individual with that condition. VALIDATION: Modified versions of previously validated comorbidity measures (simple count, Charlson, Medicare Hierarchical Condition Category), longitudinal clinical outcomes (functional decline, survival), intensity of ambulatory care (primary, specialty care visits, polypharmacy, number of eligible quality indicators (NQI)) over 1 year of care.
resultsThe most-morbid individuals (according to quintiles of GXI) had more visits (7.0 vs 3.7 primary care, 6.2 vs 2.4 specialist), polypharmacy (14.3% vs 0% had ≥14 medications), and greater NQI (33 vs 25) than the least-morbid individuals. Of the four comorbidity measures, the GXI was the strongest predictor of primary care visits, polypharmacy, and NQI (P < .001, controlling for age, sex, function-based vulnerability).
conclusionOlder adults with complex care needs, as measured by the GXI, have healthcare needs above what previously employed comorbidity measures captured. Healthcare systems could use the GXI to identify the most complex elderly adults and appropriately reimburse primary providers caring for older adults with the most complex care needs for providing additional visits and coordination of care.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.