title: Comparison of three comorbidity measures for predicting health service use in patients with osteoarthritis.
abstract: OBJECTIVE
  To compare the ability of 3 database-derived comorbidity scores, the Charlson Score, Elixhauser method, and RxRisk-V, in predicting health service use among individuals with osteoarthritis (OA).
  
  
  METHODS
  The study population comprised 306 patients who were under care for OA in the Veterans Affairs (VA) health care system. Comorbidity scores were calculated using 1 year of data from VA inpatient and outpatient databases (Charlson Score, Elixhauser method), as well as pharmacy data (RxRisk-V). Model selection was used to identify the best comorbidity index for predicting 3 health service use variables: number of physician visits, number of prescriptions used, and hospitalization probability. Specifically, Akaike's Information Criterion (AIC) was used to determine the best model for each health service outcome variable. Model fit was also evaluated.
  
  
  RESULTS
  All 3 comorbidity indices were significant predictors of each health service outcome (P < 0.01). However, based on AIC values, models using the RxRisk-V and Elixhauser indices as predictor variables were better than models using the Charlson Score. The model using the RxRisk-V index as a predictor was the best for the outcome of prescription medication use, and the model with the Elixhauser index was the best for the outcome of physician visits.
  
  
  CONCLUSIONS
  The Rx-Risk-V and Elixhauser are suitable comorbidity measures for examining health services use among patients with OA. Both indices are derived from administrative databases and can efficiently capture comorbidity among large patient populations.
authors.affiliation: Durham VAMC, Duke University Medical Center, NC 27705, USA. domin004@mc.duke.edu
authors.forename: Kelli L
authors.initials: KL
authors.lastname: Dominick
authors.forename: Tara K
authors.initials: TK
authors.lastname: Dudley
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Coffman
authors.forename: Hayden B
authors.initials: HB
authors.lastname: Bosworth
mesh_terms: D015897:Comorbidity; D003627:Data Interpretation, Statistical; D016208:Databases, Factual / Q000706:statistics & numerical data*; D016021:Epidemiologic Studies; D005544:Forecasting; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D016347:Medical Records Systems, Computerized; D018803:Models, Economic; D009657:North Carolina / Q000453:epidemiology; D010003:Osteoarthritis / Q000453:epidemiology / Q000473:pathology*