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Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
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Developing and validating a novel multisource comorbidity score from administrative data: a large population-based

Giovanni Corrao1,2, Federico Rea1,2, Mirko Di Martino3

  • 1National Centre for Healthcare Research & Pharmacoepidemiology, at the University of Milano-Bicocca, Milan, Italy.

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|December 29, 2017
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A new multisource comorbidity score (MCS) effectively predicts mortality and healthcare utilization in Italy. This validated score offers improved risk adjustment for clinical practice and health policy planning.

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Area of Science:

  • Health Services Research
  • Epidemiology
  • Biostatistics

Background:

  • Comorbidity assessment is crucial for predicting patient outcomes and healthcare costs.
  • Existing comorbidity scores may not fully capture disease burden using diverse data sources.

Purpose of the Study:

  • To develop and validate a novel multisource comorbidity score (MCS) using administrative Italian National Health System (NHS) data.
  • To assess MCS's predictive accuracy for mortality, hospital admissions, and healthcare costs.

Main Methods:

  • A 34-variable index was developed from inpatient diagnoses and outpatient prescriptions in a large Italian cohort (500,000 individuals aged 50+).
  • Weibull survival models determined variable weights.
  • Internal and external validation were performed across four Italian regions using NHS beneficiary data.

Main Results:

  • The multisource comorbidity score (MCS) demonstrated progressive increases in primary and secondary outcomes with higher scores.
  • MCS significantly improved 1-year mortality reclassification compared to existing scores (27% vs. 69%).
  • Consistent discrimination performance (AUC 0.77-0.78) was observed across all validation regions.

Conclusions:

  • The multisource comorbidity score (MCS) shows superior performance over conventional scores for predicting health outcomes in the Italian general population.
  • MCS provides a valuable tool for risk adjustment, policy planning, and identifying patients requiring targeted interventions.