Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Prognostic Impact of Charlson Comorbidity Index Obtained from Medical Records and Claims Data on 1-year Mortality and Length of Stay in Gastric Cancer Patients

위암환자에서 의무기록과 행정자료를 활용한 Charlson Comorbidity Index의 1년 이내 사망 및 재원일수 예측력 연구

  • Kyung, Min-Ho (Department of Preventive Medicine, College of Medicine, Korea University) ;
  • Yoon, Seok-Jun (Department of Preventive Medicine, College of Medicine, Korea University) ;
  • Ahn, Hyeong-Sik (Department of Preventive Medicine, College of Medicine, Korea University) ;
  • Hwang, Se-Min (Department of Preventive Medicine, College of Medicine, Korea University) ;
  • Seo, Hyun-Ju (Department of Preventive Medicine, College of Medicine, Korea University) ;
  • Kim, Kyoung-Hoon (Insurance Review and Assessment Service) ;
  • Park, Hyeung-Keun (Department of Health Policy and Management, School of Medicine, Cheju National University)
  • 경민호 (고려대학교 의과대학 예방의학교실) ;
  • 윤석준 (고려대학교 의과대학 예방의학교실) ;
  • 안형식 (고려대학교 의과대학 예방의학교실) ;
  • 황세민 (고려대학교 의과대학 예방의학교실) ;
  • 서현주 (고려대학교 의과대학 예방의학교실) ;
  • 김경훈 (건강보험심사평가원) ;
  • 박형근 (제주대학교 의과대학 의료관리학교실)
  • Published : 2009.03.31
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Abstract

Objectives : We tried to evaluate the agreement of the Charlson comorbidity index values(CCI) obtained from different sources(medical records and National Health Insurance claims data) for gastric cancer patients. We also attempted to assess the prognostic value of these data for predicting 1-year mortality and length of the hospital stay(length of stay). Methods : Medical records of 284 gastric cancer patients were reviewed, and their National Health Insurance claims data and death certificates were also investigated. To evaluate agreement, the kappa coefficient was tested. Multiple logistic regression analysis and multiple linear regression analysis were performed to evaluate and compare the prognostic power for predicting 1 year mortality and length of stay. Results : The CCI values for each comorbid condition obtained from 2 different data sources appeared to poorly agree(kappa: 0.00-0.59). It was appeared that the CCI values based on both sources were not valid prognostic indicators of 1-year mortality. Only medical record-based CCI was a valid prognostic indicator of length of stay, even after adjustment of covariables($\beta$ = 0.112, 95% CI = [0.017-1.267]). Conclusions : There was a discrepancy between the data sources with regard to the value of CCI both for the prognostic power and its direction. Therefore, assuming that medical records are the gold standard for the source for CCI measurement, claims data is not an appropriate source for determining the CCI, at least for gastric cancer.

Keywords

References

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