Mossey J M, Roos L L
J Chronic Dis. 1987;40 Suppl 1:41S-54S. doi: 10.1016/s0021-9681(87)80031-0.
Health insurance systems are generating large numbers of claims filed by physicians and hospitals for reimbursement and accounting purposes. This paper describes and evaluates a measure of health status derived from physician and hospital claims filed for a sample of older Canadians during 1970-1977. Information on the number, type, and seriousness of reported diagnoses and the number and duration of hospitalizations and surgeries during each year were combined to generate annual Illness Scales ranging from 0 to 24. Alpha coefficients, measures of internal consistency, were between 0.82 and 0.84. Consistent with high validity, Illness Scale scores increased with age, were significantly associated with other health measures, and were strongly predictive of death and hospitalization in the following year. The ability to develop valid and reliable health status measures from insurance claims substantially expands the potential use of these data for research and evaluation.
医疗保险系统产生了大量医生和医院提交的用于报销和核算目的的索赔申请。本文描述并评估了一种健康状况衡量指标，该指标源自1970年至1977年期间为加拿大老年人样本提交的医生和医院索赔申请。关于报告诊断的数量、类型和严重程度以及每年住院和手术的数量及时长的信息被整合起来，以生成范围从0到24的年度疾病量表。作为内部一致性度量的阿尔法系数在0.82至0.84之间。与高效度相符的是，疾病量表得分随年龄增长而增加，与其他健康指标显著相关，并且对次年的死亡和住院情况具有很强的预测性。从保险索赔中开发有效且可靠的健康状况衡量指标的能力极大地扩展了这些数据在研究和评估中的潜在用途。
