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Comorbidity Adjustment in Health Insurance Claim Database
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  • Journal title : Health Policy and Management
  • Volume 26, Issue 1,  2016, pp.71-78
  • Publisher : The Korean Society of Health Policy and Administration
  • DOI : 10.4332/KJHPA.2016.26.1.71
 Title & Authors
Comorbidity Adjustment in Health Insurance Claim Database
Kim, Kyoung Hoon;
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The value of using health insurance claim database is continuously rising in healthcare research. In studies where comorbidities act as a confounder, comorbidity adjustment holds importance. Yet researchers are faced with a myriad of options without sufficient information on how to appropriately adjust comorbidity. The purpose of this study is to assist in selecting an appropriate index, look back period, and data range for comorbidity adjustment. No consensus has been formed regarding the appropriate index, look back period and data range in comorbidity adjustment. This study recommends the Charlson comorbidity index be selected when predicting the outcome such as mortality, and the Elixhauser`s comorbidity measures be selected when analyzing the relations between various comorbidities and outcomes. A longer look back period and inclusion of all diagnoses of both inpatient and outpatient data led to increased prevalence of comorbidities, but contributed little to model performance. Limited data range, such as the inclusion of primary diagnoses only, may complement limitations of the health insurance claim database, but could miss important comorbidities. This study suggests that all diagnoses of both inpatients and outpatients data, excluding rule-out diagnosis, be observed for at least 1 year look back period prior to the index date. The comorbidity index, look back period, and data range must be considered for comorbidity adjustment. To provide better guidance to researchers, follow-up studies should be conducted using the three factors based on specific diseases and surgeries.
Health insurance claim database;Comorbidity adjustment;Comorbidity index;Look back period;Data range;
 Cited by
의료보장유형에 따른 폐결핵 입원환자의 재원기간과 치료결과 차이분석,김상미;이현숙;황슬기;

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