Author Response for Identifying Increased Risk of Readmission and In-hospital Mortality Using Hospital Administrative Data: The AHRQ Elixhauser Comorbidity Index

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In Reply:
The objective of our research was to develop a comorbidity index that relied solely on large administrative inpatient databases, a data source that is widely available from most states, is used in thousands of studies, and must optimize the information found in the limited clinical detail available in billing data. Because of this focus, our literature review was limited to prior articles using only administrative data, and therefore did not include either Crane et al1 or De Giorgi et al.2 Both studies predate our own, but are based on single institutions and relied at least in part on medical record review or electronic medical records data to obtain information on a history of comorbid conditions or other predictor variables available only outside the administrative record. Nonetheless, both studies demonstrate that comorbid conditions can be used to predict the risk of readmission as part of a larger prediction model and should be considered by researchers with access to data beyond administrative inpatient billing data.
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