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Chronic diseases and physical functioning: development and validation of an ICD-coded multimorbidity index

a MiCDA Research Project Description

Investigators: Melissa Y. Wei, Kenneth M. Langa

Funding: Society of General Internal Medicine, 2017-2018 (Check No. 5087 dad 18May17)

Multimorbidity, the coexistence of multiple chronic conditions, poses a major and growing challenge to aging adults, their families, and healthcare systems. Most older adults have multiple chronic conditions that interact to profoundly affect physical functioning and health-related quality of life. Despite this, critical gaps remain in the measurement of multimorbidity. In particular, there are few practical tools to guide clinicians, researchers, and policymakers who seek to improve the care for older adults. Current measures for multimorbidity have used mortality, healthcare cost, and utilization, but have not focused on patient-centered outcomes to quantify burden of disease. To bridge these gaps, this proposal aims to develop and validate a new multimorbidity index for use in ICD-coded conditions.

The proposed studies will use unique data linkages between patient-reported outcomes in the nationally-representative Health and Retirement Study and Medicare claims to develop and internally validate a multimorbidity index for International Classification of Diseases (ICD)-coded chronic conditions weighted to physical functioning. The successful completion of these studies will yield a validated multimorbidity measure that captures the impact of coexisting chronic diseases on physical functioning in aging adults relevant for clinical care, research, and policy.

The training and professional development acquired through this award will contribute to the candidate?s long-term goal to be an independent clinician-investigator focused on improving the management, quality of care, and prognosis of vulnerable older adults with multimorbidity.

Research Signature Themes:

Survey Measurement and Methods: Methods
Health and well-being in later life: Other