Skip to main content

Performance of comorbidity, risk adjustment, and functional status measures in expenditure prediction for patients with diabetes.

Publication ,  Journal Article
Maciejewski, ML; Liu, C-F; Fihn, SD
Published in: Diabetes Care
January 2009

OBJECTIVE: To compare the ability of generic comorbidity and risk adjustment measures, a diabetes-specific measure, and a self-reported functional status measure to explain variation in health care expenditures for individuals with diabetes. RESEARCH DESIGN AND METHODS: This study included a retrospective cohort of 3,092 diabetic veterans participating in a multisite trial. Two comorbidity measures, four risk adjusters, a functional status measure, a diabetes complication count, and baseline expenditures were constructed from administrative and survey data. Outpatient, inpatient, and total expenditure models were estimated using ordinary least squares regression. Adjusted R(2) statistics and predictive ratios were compared across measures to assess overall explanatory power and explanatory power of low- and high-cost subgroups. RESULTS: Administrative data-based risk adjusters performed better than the comorbidity, functional status, and diabetes-specific measures in all expenditure models. The diagnostic cost groups (DCGs) measure had the greatest predictive power overall and for the low- and high-cost subgroups, while the diabetes-specific measure had the lowest predictive power. A model with DCGs and the diabetes-specific measure modestly improved predictive power. CONCLUSIONS: Existing generic measures can be useful for diabetes-specific research and policy applications, but more predictive diabetes-specific measures are needed.

Duke Scholars

Published In

Diabetes Care

DOI

EISSN

1935-5548

Publication Date

January 2009

Volume

32

Issue

1

Start / End Page

75 / 80

Location

United States

Related Subject Headings

  • Veterans
  • United States
  • Risk Adjustment
  • Retrospective Studies
  • Predictive Value of Tests
  • Outpatients
  • Middle Aged
  • Male
  • Inpatients
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Maciejewski, M. L., Liu, C.-F., & Fihn, S. D. (2009). Performance of comorbidity, risk adjustment, and functional status measures in expenditure prediction for patients with diabetes. Diabetes Care, 32(1), 75–80. https://doi.org/10.2337/dc08-1099
Maciejewski, Matthew L., Chuan-Fen Liu, and Stephan D. Fihn. “Performance of comorbidity, risk adjustment, and functional status measures in expenditure prediction for patients with diabetes.Diabetes Care 32, no. 1 (January 2009): 75–80. https://doi.org/10.2337/dc08-1099.
Maciejewski, Matthew L., et al. “Performance of comorbidity, risk adjustment, and functional status measures in expenditure prediction for patients with diabetes.Diabetes Care, vol. 32, no. 1, Jan. 2009, pp. 75–80. Pubmed, doi:10.2337/dc08-1099.

Published In

Diabetes Care

DOI

EISSN

1935-5548

Publication Date

January 2009

Volume

32

Issue

1

Start / End Page

75 / 80

Location

United States

Related Subject Headings

  • Veterans
  • United States
  • Risk Adjustment
  • Retrospective Studies
  • Predictive Value of Tests
  • Outpatients
  • Middle Aged
  • Male
  • Inpatients
  • Humans