The prevalence of chronic conditions and medical expenditures of the elderly by chronic condition indicator (CCI)

Chi, Mei‐Ju; Lee, Cheng Yi; Wu, Shwu Chong

doi:10.1016/j.archger.2010.04.017

Cited by 60 publications

(41 citation statements)

References 13 publications

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“…The 2 definitions partially overlap, but our definition covered a larger population of pediatric inpatients with medical complexity than the definition used in the study by Slonim et al Previous studies have used similar ICD-9-CM codes in administrative databases to define chronic conditions among US children, 7,14,17 and the HCUP Chronic Condition Indicator has also been previously used to study adults. 18,19 The Chronic Condition Indicator in the HCUP data may provide a useful tool for pediatric medical care quality research; however, no published study has used this tool in pediatric populations. 12 Consistent with an earlier study, 3 our results show that drug errors were infrequent (,0.1%) compared with other categories of medical errors in pediatric inpatients.…”

Section: Discussionmentioning

confidence: 99%

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Medical Errors in US Pediatric Inpatients With Chronic Conditions

2012

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WHAT'S KNOWN ON THIS SUBJECT: Iatrogenic medical errors are an important medical care issue in the United States. Errors may be particularly important in children with chronic health conditions, especially as the prevalence of chronic conditions is increasing in children. WHAT THIS STUDY ADDS:In a nationally representative sample, we found that pediatric inpatients with chronic conditions were at a significantly higher risk for medical errors than inpatient children without chronic conditions, controlling for severity of illness, length of stay, and other potential confounders. abstract OBJECTIVE: To investigate the association between chronic conditions and iatrogenic medical errors in US pediatric inpatients. METHODS:The 2006 Kids' Inpatient Database (KID) was analyzed. Medical errors were defined by using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Medical error rates per 100 hospital discharges and per 1000 inpatient days were calculated. Logistic regression models were fitted to study the association between number of chronic conditions and medical errors, controlling for patient characteristics, hospital characteristics, disease severity, and length of stay. RESULTS:In the 2006 KID, 22.3% of pediatric inpatients had 1 chronic condition, 9.8% had 2 chronic conditions, and 12.0% had $3 chronic conditions. The overall medical error rate per 100 discharges was 3.0 (95% confidence interval [CI]: 2.8-3.3); it was 5.3 (95% CI: 4.9-5.7) in children with chronic conditions and 1.3 (95% CI: 1.2-1.3) in children without chronic conditions. The medical error rate per 1000 inpatient days was also higher in children with chronic conditions. The association between chronic conditions and medical errors remained statistically significant in logistic regression models adjusting for patient characteristics, hospital characteristics, disease severity, and length of stay. In the adjusted model, the odds ratio of medical errors for children with 1 chronic condition was 1.40 (95% CI: 1.32-1.48); for children with 2 conditions, the OR was 1.55 (95% CI: 1.45-1.66); and for children with 3 conditions, the OR was 1.66 (95% CI: 1.53-1.81). CONCLUSIONS:The number of chronic conditions was significantly associated with iatrogenic medical errors in pediatric inpatients. Pediatrics 2012;130:e786-e793 AUTHORS:

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Section: Discussionmentioning

confidence: 99%

“…In addition, our measurement of chronic conditions relied on the Chronic Condition Indicator variable provided in the KID. Although the Chronic Condition Indicator system was based on previous comprehensive research 12 and has been used by others, 18,19 this tool needs to be further evaluated and validated in pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

Medical Errors in US Pediatric Inpatients With Chronic Conditions

2012

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“…Clinical characteristics included the presence of a chronic condition, technology assistance, and a disability. To identify chronic conditions, we used the Agency for Healthcare Research and Quality's Chronic Condition Indicator classification system, [24][25][26] which dichotomizes ∼14 000 International Classification of Diseases, Ninth Revision diagnosis codes into chronic or nonchronic conditions and aggregates chronic conditions into 1 of 18 mutually exclusive clinical groups. The Chronic Condition Indicator defines chronic conditions as those lasting $12 months that place limitations on self-care, independent living, and social interaction or are associated with the need for ongoing intervention with medical products, services, and special equipment.…”

Section: Demographic and Clinical Characteristics Of The Childrenmentioning

confidence: 99%

Comparison of Health Care Spending and Utilization Among Children With Medicaid Insurance

et al. 2015

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“…We applied the chronic condition indicator 6 to categorize ICD-9 diagnosis codes into one of two categories: chronic or not chronic. The chronic condition indicator has been validated and applied in academic research [16,29].…”

Section: Methodsmentioning

confidence: 99%