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Related Experiment Videos

Predicting mortality and healthcare utilization with a single question.

Karen B DeSalvo1, Vincent S Fan, Mary B McDonell

  • 1Section of General Internal Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA.

Health Services Research
|July 22, 2005
PubMed
Summary

General self-rated health (GSRH) effectively predicts mortality and clinical events in veteran patients. A single GSRH question performs comparably to longer health assessments, proving useful for risk stratification at the point of care.

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Area of Science:

  • Health outcomes research
  • Epidemiology
  • Geriatric medicine

Background:

  • General self-rated health (GSRH) is a key indicator of health status.
  • Assessing the predictive validity of single-item versus multi-item health measures is crucial for efficient clinical practice.
  • Veteran populations present unique health challenges and require tailored assessment tools.

Purpose of the Study:

  • To compare the predictive and discriminative abilities of single-item general self-rated health (GSRH) measures against multi-item instruments for mortality and clinical events.
  • To evaluate the utility of GSRH in stratifying risk among veteran patients.
  • To determine if a single GSRH question is as effective as longer health surveys in predicting adverse health outcomes.

Main Methods:

Related Experiment Videos

  • Analysis of prospective cohort data from 21,732 veteran patients in the Veterans Affairs Ambulatory Care Quality Improvement Project (ACQUIP).
  • Logistic regression models were used to assess the odds of events based on GSRH response categories.
  • Receiver operating characteristic curves and area under the curve (AUC) were employed to compare the discriminative ability of GSRH against the SF-36 physical component score (PCS), mental component score (MCS), and Seattle index of comorbidity (SIC).

    • Main Results:

    • General self-rated health (GSRH), PCS, and SIC demonstrated comparable AUC for predicting mortality (AUC ≈0.73-0.74), hospitalization (AUC ≈0.60-0.64), and high outpatient use (AUC ≈0.60-0.61).
    • The MCS showed statistically inferior discriminatory performance for mortality and hospitalization compared to other predictors (p<.001).
    • Patients reporting "poor" health had significantly higher odds of mortality and healthcare resource utilization.

    Conclusions:

    • The general self-rated health (GSRH) question effectively stratifies patients by risk for adverse health outcomes.
    • A single GSRH question provides predictive power comparable to longer, multi-item health assessments.
    • GSRH is a valuable, point-of-care tool for identifying high-risk veteran patients.