Validating a method to assess disease burden from insurance claims.

OBJECTIVES: To validate a method that estimates disease burden as disability-adjusted life-years (DALYs) from insurance claims and death records for the purpose of identifying the conditions that place the greatest burden of disease on an insured population.

STUDY DESIGN: Comparison of the DALYs generated from death records and insurance claims with functional status and health status reported by individuals who were insured with one of HealthPartners' commercial products and completed a health assessment in 2011, 2012, or 2013.

METHODS: We calculated values of Spearman's ρ, the rank-order coefficient of correlation, for the correlation of DALYs with self-reported function and self-reported health. We did the same for the number of medical conditions per member and the cost of claims per member.

RESULTS: The Spearman's ρ values for the correlation of DALYs with function were -0.241, -0.238, and -0.229 in 2011, 2012, and 2013, respectively (all P <.0001). The respective Spearman's ρ values for the correlation of DALYs with health were -0.197, -0.189, and -0.192 (all P <.0001). These Spearman's ρ values were similar in magnitude to those for the correlation of the number of medical conditions per member with function (-0.212, -0.213, and -0.205) and health (-0.199, -0.196, and -0.198) over the 3 years. The Spearman's ρ values for the correlation of DALYs with function and health were greater than or equal to those for the correlation of cost of claims per member with function (-0.144, -0.193, and -0.186) and greater than those for the cost of claims per member with health (-0.126, -0.150, and -0.151).

CONCLUSIONS: Health plans can use DALYs calculated from their own health insurance claims and death records as a valid and inexpensive method to identify the conditions that place the greatest burden of poor function and ill health on their insured populations.