Stanford Clinical Excellence Research Center Collaborator Search
27 September 2011
Objectives The project seeks to understand for cohorts of patients with major chronic medical conditions from date of inception the progression of illness severity, health service utilization, and total heath care spending ("costs")
Background The Clinical Excellence Research Center (CERC) at Stanford designs and tests innovative care models using diverse design teams from multiple Stanford schools.
To assist in clinical target selection, we seek a research collaborator with a database from an industrialized country that captures from illness inception: progression of severity of illness, service utilization and total health spending for a large stable population of at least 500,000 individuals. Reports extracted from such a database would permit the estimation of future lifetime spending and disability from inception and through each stage of disease progression for major medical conditions that cause the most disability and consume the most health spending in an industrialized country. This cannot be accomplished with US databases because Americans frequently switch health insurers and the alternative data source, long-term electronic clinical databases, are insufficiently developed.
Ideally, we would find a partner with already completed analyses that portray from the point of disease inception how the present value of future spending on health care and disability benefits varies as age and disease stage progress.
Context We seek a partner who can extract information from databases or reports from national, provincial, or other regional sources. We do not seek direct access to patient-identified databases or other security-sensitive materials.
Focus The focus would be on 10-15 chronic conditions causing the most morbidity, mortality, and health care costs. These include the following:
a) Heart disease (coronary insufficiency, ischemic heart disease, myocardial infarction, congestive heart failure, dysrhythmia)
b) Asthma and chronic obstructive pulmonary disease (COPD: chronic bronchitis and emphysema)
c) Mental disorders: depression, bipolar disease
d) Cancer (especially breast, lung, colon, and prostate)
e) Hypertension
f) Trauma
g) Cerebrovascular disease (stroke, transient ischemic attack)
h) Arthritis (especially osteoarthritis)
i) Diabetes mellitus (type 1 and type 2)
j) Back problems
k) Obesity
l) Smoking
m) Alcoholism and other substance abuse
n) Renal failure
See icd9 codes below.
Data types
Optimally, the source material will also allow assessment for multiple comorbidities (greater than the sum of parts)
If possible, the source material will enumerate utilization rates rather than absolute costs, allowing projections based on costs in other settings
Cohort members should be tracked by age of onset and intervals before common complications.
ICD-9 codes
CATEGORY ICD-9-CM CODES
Alcoholism V11.3, V79.1, 291, 303.9, 303.0, 291.9
Asthma 493.0, 493.1, 493.9, 493.2, V17.5, 493.8, 493.82
Back Pain 724.2, 847.9, 724.0-724.9, 721.0-721.9
CAD 414.0, 414.2, 414.01,414.8, 410-414
Cancer, Breast 174.0-174.9, 175.0-175.9, V86.0, V10.3
Cancer, Colon 153.0-153.9
Cancer, Lung 231.0-231.9
Cancer, Prostate 185.0-185.9, V10.46
CHF 428.0-428.9
Colitis 556.0-556.9, 558.3, 009.1
COPD 492.0-492.8, 496.0-496.9
CVA/TIA 434.0-434.9, 430,431, 437.1, 435.0-435.9
Dementia 294.0-294.9, 331.0-331.9, 290.0-290.9
Depression 296.0-296.9, 298.0-298.9, 300.4, V79.0, 311
Diabetes mellitus 250.0-250.9, 249.0-249.9
Hypertension 401.0-401.9, 997.91
Neck/Shoulder pain 723.0-723.9,718.0-719.9, 729.0-729.9, 721.0-721.9
Obesity 278.0-278.9, V77.8
Osteoarthritis 715.0-715.9
Parkinsonism 332.0-332.9,
Renal Insufficiency 585.0-585.9, 753.1
Substance Abuse, other 305.0-305.9,
