Morbidity severity classifying routine consultations from English and Dutch general practice indicated physical health status

• Published in: Journal of clinical epidemiology Vol. 61; no. 4; pp. 386.e1 - 386.e9
• Main Authors: Kadam, U.T, Schellevis, F.G, van der Windt, D.A.W.M, de Vet, H.C.W, Bouter, L.M, Croft, P.R
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.2008; Elsevier; Elsevier Limited
• Subjects: Adult; Age Factors; Aged; Biological and medical sciences; Chronic illnesses; Classification; Clinical medicine; Comorbidity; England; Epidemiology; Family Practice; Female; General aspects; General practice; Health care; Health services; Health Status Disparities; Health Status Indicators; Hospitals; Humans; Internal Medicine; Male; Medical records; Medical sciences; Middle Aged; Morbidity; Netherlands; Odds Ratio; Patient Acceptance of Health Care; Planification. Prevention (methods). Intervention. Evaluation; Primary care; Public health. Hygiene; Public health. Hygiene-occupational medicine; Reproducibility of Results; Research Design; Sex Factors; Socioeconomic Factors; Studies; Validity; Netherlands; Europe; England; United Kingdom > UK; Medical records; General practice; Health status indicators; Comorbidity; Morbidity; Classification; Health; Indicator; English; Concomitant disease; Health status; Polypathology; Consultation; Medical record; Dutch
• ISSN: 0895-4356; 1878-5921
• DOI: 10.1016/j.jclinepi.2007.05.014

Abstract Objective To investigate the construct validity of morbidity severity scales based on routine consultation data by studying their associations with sociodemographic factors and physical health. Study Design and Setting Study participants were 11,232 English adults aged 50 years and over and 9,664 Dutch adults aged 18 years and over, and their consulting morbidity data in a 12-month period were linked to their physical health data. Consulters with any of 115 morbidities classified on four ordinal scales of severity (“chronicity,” “time course,” “health care use,” and “patient impact”) were compared to all other consulters. Results As hypothesized, in both countries, morbidity severity was associated with older age, female gender, more deprivation (all comparisons P ≤ 0.05), and poor physical health (all trends P < 0.001). The estimated strengths of association of poor physical health with the highest severity category expressed as odds ratios, for each of the four scales, were 5.4 for life-threatening on the “chronicity” scale, 1.8 for time course, 2.8 for high health care use, and 3.7 for high patient impact. Conclusions Four scales of morbidity severity have been validated in English and Dutch settings, and they offer the potential to use simple routine consultation data as an indicator of physical health status in populations from general practice.