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

a MiCDA Pilot Project Description

Investigators: Melissa Y. Wei

Funding: Michigan Center on the Demography of Aging, 2017-2018

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 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 aging 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 granular 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 successful completion of this project will yield a valid measure of multimorbidity that captures the impact of
chronic conditions on physical functioning in older adults crucial for patient care, research, and policy. These studies will lay the foundation for future studies that test the implementation of the index in clinical settings to manage complex patients, allocate resources, and target high-risk adults to prevent multimorbidity progression and complications.

Research Signature Theme:

Health and well-being in later life: Chronic Disease

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