Reproducibility in the Assessment of the Components of a Clinical Complexity Index

Excerpt

Clinical complexity (CC) represents one of the most relevant challenges of modern medicine, and its quantification is crucial both to stratify the clinical risk and for a fair hospital reimbursement policy.^1‐3 CC is a multifaceted condition that encompasses biological (e.g., age, multimorbidity, frailty) and non-biological (e.g., socioeconomic, cultural, environmental, and behavioral) components.^{4, 5} On this basis, a vectorial model of CC has been set up in which each vector expresses the dynamic changes over time of each component.⁵ Although this model cannot but be an approximation of CC, it is able to take into account its determining factors all at once. To allow its use, each vector has been graded following a consensus meeting during which the five most representative variables of each CC domain were selected.⁶ However, a score made of a series of variables could be a source of variability. For this reason, we have performed an interobserver agreement study. …