Table 1.
Frailty measures for administrative claims data
| Author (y) | Database/population (study year) | Outcomes | Predictors | ||
|---|---|---|---|---|---|
| Development | Validation | ||||
| Clinical knowledge-driven selection | Lunney et al.42) (2002) | Medicare database (USA)42) | Not applicable | None | Presence (yes/no) of any of 11 conditions based on ICD diagnosis codes |
| - Medicare 0.1% sample (1993–1998)42) | |||||
| Abrams et al.43) (2003) | Medicare database (USA) | Not applicable | Vulnerable Elders Survey | Presence (yes/no) of any of 10 conditions based on ICD diagnosis codes (Johns Hopkins Adjusted Clinical Groups) | |
| - HMO in Israel (2008)54) | Mortality | ||||
| - Major non-cardiac surgery, emergency general surgery, orthopedic surgery patients in Canada (2002–2014)80-83) | Complications | ||||
| Discharge disposition | |||||
| Costs | |||||
| Chrischilles et al.44) (2014) | Medicare database (USA) | Not applicable | Mortality | Presence (yes/no) of any or ≥2 of 16 conditions based on ICD diagnosis and HCPCS codes | |
| - Acute MI patients (2007–2008)44) | Cardiac catheterization | ||||
| - Kidney cancer patients (2000–2009)84) | Complications | ||||
| Costs | |||||
| JEN Associates45,46) (2008) | Medicare database (USA)45,86) | Not applicable | Mortality | Count of the number of 13 conditions present based on ICD diagnosis codes (JEN-Frailty Index) | |
| - Spouses of AD patients (2001–2005)85) | NH admission | ||||
| - National Long-Term Care Survey (2004)60) | Costs | ||||
| - Medicare 5% sample (2011–2014) | Disability | ||||
| Hope et al.47) (2015) | Medicare database (USA) | Not applicable | Mortality | Presence (yes/no) of nursing facility claims or 11 conditions based on ICD diagnosis codes | |
| - ICU patients (2004–2008)47) | |||||
| Soong et al.53,87) (2015) | Inpatient claims database, England | Not applicable | Mortality | Presence (yes/no) of any of 9 conditions based on ICD diagnosis codes | |
| - HES database (2005–2013)53,87) | Discharge disposition | ||||
| Readmission | |||||
| Medicare database (USA) | Not applicable | Costs | Presence (yes/no) of ≥2 of 12 conditions based on ICD diagnosis codes and HCPCS codes (specified by Kim and Schneeweiss)31) | ||
| Joynt et al.8) (2017) | - Medicare 20% sample (2011–2012)7,8) | ||||
| Orkaby et al.49) (2018) | VA claims database (USA) | Not applicable | Mortality | Proportion of 31 health deficits present based on ICD diagnosis, CPT, and HCPCS codes | |
| - National sample (2002–2012)49) | |||||
| McIsaac et al.51) (2019) | Administrative claims database (Canada) | Not applicable | Mortality | Proportion of 30 health deficits present based on ICD diagnosis codes, drugs, assistive device codes, and living environment (preoperative Frailty Index) | |
| - Major non-cardiac surgery (2002–2015)51,88 | Discharge disposition | ||||
| Data-driven selection without a reference standard | Gilbert et al.37) (2018) | Inpatient claims database, England | Frailty cluster (from cluster analysis) | Mortality | Includes 109 ICD diagnosis variables |
| - HES database (2005–2013)37) | Prolonged hospitalization | ||||
| - Hospital cohorts37) | Readmission | ||||
| Frailty phenotype | |||||
| Deficit-accumulation FI | |||||
| Data-driven selection with a reference standard | Rosen et al.50) (2000) | VA claims database (USA) | Disability | Disability | Includes 13 conditions based on ICD diagnosis codes |
| - Long-term care (1996–1997)50,89) | |||||
| Dubois et al.52) (2010) | Prescription claims database (Canada) | Functional status score | Mortality | Includes 11 prescription drug categories | |
| - PRISMA cohort (2001–2005)52 | Disability | ||||
| Hospitalization | |||||
| NH admission | |||||
| Davidoff et al.40) (2013) | Medicare database (USA) | Disability | Mortality | Includes sex, Medicaid enrollment, number of office visits, 8 health care visit types, 3 health care services, 9 procedures, 6 DMEs, and 2 imaging tests based on CPT and HCPCS codes, and geographical regions | |
| - MCBS cohort (2001–2005)40) | Disability | ||||
| - HRS cohort (2008-2010)56) | Frailty phenotype | ||||
| - SEER-Medicare cohort (1999–2007)90,91) | Deficit-accumulation FI | ||||
| Faurot et al.48) (2015) | Medicare database (USA) | Disability | Mortality | Includes age, sex, race, and 23 conditions based on ICD diagnosis, CPT, or HCPCS codes | |
| - MCBS cohort (2006)48) | Disability | ||||
| - Medicare beneficiaries with or without influenza vaccination (2007–2008)62) | Falls | ||||
| - ARIC cohort (2011–2013)58) | Mobility impairment | ||||
| - MarketScan Medicare (2013)63) | Frailty phenotype | ||||
| - HRS cohort (2008-2010)56) | Deficit-accumulation FI | ||||
| Costs | |||||
| Segal et al.39,55) (2017) | Medicare database (USA) | Frailty phenotype | Mortality | Includes age, sex, race, Charlson Comorbidity Index, past hospitalization, and 16 conditions based on ICD diagnosis codes | |
| - CHS cohort (1992–1993/1997)39) | Disability | ||||
| - NHATS cohort (2000)55) | Hospitalization | ||||
| - Medicare TAVR cohort (2011–2015)64) | Fracture | ||||
| - HRS cohort (2008-2010)56) | NH admission | ||||
| Frailty phenotype | |||||
| Deficit-accumulation FI | |||||
| Kim et al.41) (2018) | Medicare database (USA) | Deficit-accumulation FI | Mortality | Includes 52 ICD diagnosis variables, 25 CPT variables, and 16 HCPCS variables | |
| - MCBS cohort (2006–2007/2011–2012)41) | Disability | ||||
| - HRS cohort (2008–2010)56,57) | Hospitalization | ||||
| SNF stay | |||||
| NH admission | |||||
| Falls | |||||
| Frailty phenotype | |||||
| Deficit-accumulation FI | |||||
AD, Alzheimer disease; ARIC, Atherosclerosis Risk in Communities; CHS, Cardiovascular Health Study; CPT, Current Procedural Terminology; DME, durable medical equipment; FI, frailty index; HCPCS, Healthcare Common Procedure Coding System; HES, Hospital Episode Statistics; HMO, health maintenance organization; HRS, Health and Retirement Study; ICD, International Classification of Diseases; ICU, intensive care unit; MCBS, Medicare Current Beneficiary Survey; MI, myocardial infarction; NH, nursing home; NHATS, National Health and Aging Trends Study; PRISMA, Program of Research to Integrate Services for the Maintenance of Autonomy; SEER, Surveillance, Epidemiology, and End Results; TAVR, transcatheter aortic valve replacement; VA, Veterans Affairs.