Wei MY, Leis AM, Vasilyev A, Kang AJ. Development and validation of new multimorbidity-weighted index for ICD-10-coded electronic health record and claims data: an observational study.
BMJ Open 2024;
14:e074390. [PMID:
38365301 PMCID:
PMC10875470 DOI:
10.1136/bmjopen-2023-074390]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 01/31/2024] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVE
Map multimorbidity-weighted index (MWI) conditions to International Classification of Diseases, 10th Revision (ICD-10), expand the conditions and codes to develop a new ICD-10-coded MWI (MWI-ICD10) and updated MWI-ICD9, and assess their consistency.
DESIGN
Population-based retrospective cohort.
SETTING
Large medical centre between 2013 and 2017.
PARTICIPANTS
Adults ≥18 years old with encounters in each of 4 years (2013, 2014, 2016, 2017).
MAIN OUTCOME MEASURES
MWI conditions mapped to ICD-10 codes, and additional conditions and codes added to produce a new MWI-ICD10 and updated MWI-ICD9. We compared the prevalence of ICD-coded MWI conditions within the ICD-9 era (2013-2014), within the ICD-10 era (2016-2017) and across the ICD-9-ICD-10 transition in 2015 (washout period) among adults present in both sets of comparison years. We computed the prevalence and change in prevalence of conditions when using MWI-ICD10 versus MWI-ICD9.
RESULTS
88 175 adults met inclusion criteria. Participants were 60.8% female, 50.5% white, with mean age 54.7±17.3 years and baseline MWI-ICD9 4.47±6.02 (range 0-64.33). Of 94 conditions, 65 had <1% difference across the ICD-9-ICD-10 transition and similar minimal changes within ICD coding eras.
CONCLUSIONS
MWI-ICD10 captured the prevalence of chronic conditions nearly identically to that of the validated MWI-ICD9, along with notable but explicable changes across the ICD-10 transition. This new comprehensive person-centred index enables quantification of cumulative disease burden and physical functioning in adults as a clinically meaningful measure of multimorbidity in electronic health record and claims data.
Collapse