Evidence map›Paper›PMID 39212052›Full record

ArticleHealth services research2025

Capturing the care of complex community-based health center patients: A comparison of multimorbidity indices and clinical classification software.

Suparna M Navale, Siran Koroukian, Nicole Cook, Anna Templeton, Brenda M McGrath, Laura Crocker, Wyatt P Bensken, Ana R Quiñones, Nicholas K Schiltz, Melissa Y Wei and 1 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Suparna M NavaleOCHIN, Inc., Portland, Oregon, USA.ORCID 0000-0003-0782-8591
Siran KoroukianDepartment of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Nicole CookOCHIN, Inc., Portland, Oregon, USA.
Anna TempletonOCHIN, Inc., Portland, Oregon, USA.
Brenda M McGrathOCHIN, Inc., Portland, Oregon, USA.ORCID 0000-0003-4208-1059
Laura CrockerOCHIN, Inc., Portland, Oregon, USA.
Wyatt P BenskenOCHIN, Inc., Portland, Oregon, USA.ORCID 0000-0002-2597-9732
Ana R QuiñonesDepartment of Family Medicine, and OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, Oregon, USA.
Nicholas K SchiltzFrances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA.
Melissa Y WeiDivision of General Internal Medicine & Health Services Research, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA.
Kurt C StangeCenter for Community Health Integration, Case Western Reserve University, Cleveland, Ohio, USA.

Funding

Long-Term Effects of COVID-19 and Health Care Delivery Changes on Populations Living with Multiple Chronic ConditionsR01AG074946 · NIA · CASE WESTERN RESERVE UNIVERSITY · PI COOK, NICOLE JILL, STANGE, KURT C · 2021 to 2025
$2.5M
Long-Term Effects of COVID-19-induced Health Care Delivery Changes on Patient & Workforce Processes & Outcomes in Safety Net Practices Caring for Health Disparity PopulationsR01MD016389 · NIMHD · CASE WESTERN RESERVE UNIVERSITY · PI COOK, NICOLE JILL, STANGE, KURT C · 2022 to 2024
$1.5M
Cumulative and Synergistic Impact of Chronic Diseases on Physical Functioning in Older Adults: Development and Validation of a Novel Measure of MultimorbidityK23AG056638 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI WEI, MELISSA · 2017 to 2022
$1.0M
NIA NIH HHS 1R01 AG074946-01NIA NIH HHS K23 AG056638NIA NIH HHS K23AG056638-01NIA NIH HHS R01 AG074946NIMHD NIH HHS R01 MD016389
6 · The paper itself

Abstract

objectiveTo compare morbidity burden captured from multimorbidity indices and aggregated measures of clinically meaningful categories captured in primary care community-based health center (CBHC) patients. DATA SOURCES AND STUDY

settingElectronic health records of patients seen in 2019 in OCHIN's national network of CBHCs serving patients in rural and underserved communities. STUDY

designAge-stratified analyses comparing the most common conditions captured by the Charlson, Elixhauser, and Multimorbidity Weighted (MWI) indices, and Classification Software Refined (CCSR) and Chronic Condition Indicator (CCI) algorithms. DATA COLLECTION/EXTRACTION

methodsActive ICD-10 conditions on patients' problem list in 2019. PRINCIPAL

findingsApproximately 35%-56% of patients with at least one condition are not captured by the Charlson, Elixhauser, and MWI indices. When stratified by age, this range broadens to 9%-90% with higher percentages in younger patients. The CCSR and CCI reflect a broader range of acute and chronic conditions prevalent among CBHC patients.

conclusionThree commonly used indices to capture morbidity burden reflect conditions most prevalent among older adults, but do not capture those on problem lists for younger CBHC patients. An index with an expanded range of care conditions is needed to understand the complex care provided to primary care populations across the lifespan.

Indexed as

Community Health CentersMultimorbidityPrimary Health CareSoftwareAdolescentAdultAgedAged, 80 and overAge FactorsChronic DiseaseElectronic Health RecordsFemaleHumansInternational Classification of DiseasesMaleMiddle Agedchronic diseasecommunity‐based health centercomorbiditymeasurementmultimorbidity

Identifiers

PMID39212052
PMCPMC11782088

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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.