ArticleBMJ open2021
Implementing the US Department of Health and Human Services definition of multimorbidity: a comparison between billing codes and medical record review in a population-based sample of persons 40
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed.
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- The Influence of Body Mass Index on Biomarkers of Cellular Senescence in Older Adults.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025Article
- Trends in Anxiety and Depression Among Individuals With Rheumatoid Arthritis: A Population-Based Study.The Journal of rheumatology · 2025Article
- Incidence and Prevalence of Alzheimer's Disease in Medicare Beneficiaries.Neurology and therapy · 2025Article
- Comorbidity clusters in patients with rheumatoid arthritis identify a patient phenotype with a favourable prognosis.Annals of the rheumatic diseases · 2024Article
- Abdominal Body Composition Reference Ranges and Association With Chronic Conditions in an Age- and Sex-Stratified Representative Sample of a Geographically Defined American Population.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Article
- Multimorbidity in Atherosclerotic Cardiovascular Disease and Its Associations With Adverse Cardiovascular Events and Healthcare Costs: A Real-World Evidence Study.Journal of health economics and outcomes research · 2024Article
- Risk of Adult Hypertension in Offspring From Pregnancies Complicated by Hypertension: Population-Based Estimates.Hypertension (Dallas, Tex. : 1979) · 2023Article
- Plasma biomarkers for prediction of Alzheimer's disease neuropathologic change.Acta neuropathologica · 2023Article
- Article
- Using Unsupervised Machine Learning Methods to Cluster Comorbidities in a Population-Based Cohort of Patients With Rheumatoid Arthritis.Arthritis care & research · 2023Article
- Incident Heart Failure With Mildly Reduced Ejection Fraction: Frequency, Characteristics, and Outcomes.Journal of cardiac failure · 2023Article
- Clinical Multiteam System Composition and Complexity Among Newly Diagnosed Early-Stage Breast, Colorectal, and Lung Cancer Patients With Multiple Chronic Conditions: A SEER-Medicare Analysis.JCO oncology practice · 2023Article
- Racial Differences in Multimorbidity and Comorbidities in Rheumatoid Arthritis.Arthritis care & research · 2023Article
- Employment Characteristics and Risk of Hospitalization Among Older Adults Participating in the Mayo Clinic Biobank.Mayo Clinic proceedings. Innovations, quality & outcomes · 2022Article
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Authors and funding
9 authors.
Funding
Abstract
objectiveTo assess the validity of the US Department of Health and Human Services (DHHS) definition of multimorbidity using International Classification of Diseases, ninth edition (ICD-9) codes from administrative data.
designCross-sectional comparison of two ICD-9 billing code algorithms to data abstracted from medical records.
settingOlmsted County, Minnesota, USA.
participantsAn age-stratified and sex-stratified random sample of 1509 persons ages 40-84 years old residing in Olmsted County on 31 December 2010. STUDY MEASURES: Seventeen chronic conditions identified by the US DHHS as important in studies of multimorbidity were identified through medical record review of each participant between 2006 and 2010. ICD-9 administrative billing codes corresponding to the 17 conditions were extracted using the Rochester Epidemiology Project records-linkage system. Persons were classified as having each condition using two algorithms: at least one code or at least two codes separated by more than 30 days. We compared the ICD-9 code algorithms with the diagnoses obtained through medical record review to identify persons with multimorbidity (defined as ≥2, ≥3 or ≥4 chronic conditions).
resultsUse of a single code to define each of the 17 chronic conditions resulted in sensitivity and positive predictive values (PPV) ≥70%, and in specificity and negative predictive values (NPV) ≥70% for identifying multimorbidity in the overall study population. PPV and sensitivity were highest in persons 65-84 years of age, whereas NPV and specificity were highest in persons 40-64 years. The results varied by condition, and by age and sex. The use of at least two codes reduced sensitivity, but increased specificity.
conclusionsThe use of a single code to identify each of the 17 chronic conditions may be a simple and valid method to identify persons who meet the DHHS definition of multimorbidity in populations with similar demographic, socioeconomic, and health care characteristics.
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