Chronic Conditions

Code

The Chronic Conditions data mart implements two different chronic condition groupers: one defined by CMS and the other defined by Tuva. We started defining chronic conditions in Tuva after struggling to use the CMS logic, either because certain chronic conditions were missing (e.g. non-alcoholic fatty liver disease, MASH, etc.) or because existing definitions were unsatisfactory (e.g. type 1 and type 2 diabetes are considered the same condition by CMS).

Tuva Chronic Conditions are defined and/or reviewed by medically-trained clinical informaticists.

The Chronic Conditions data mart implements two groupers for classifying chronic condition categories:

CMS: This version uses the logic created by CMS. There are 30 CCW Chronic Condition categories, available for file years 2017 forward, and 40 other chronic health, mental health, substance abuse, and potentially disabling condition categories available for file years 2000 forward. These reference only ICD-10 diagnosis codes and have modified look-back periods, qualifying claims, and codes. You can read more about CMS's logic here.

Tuva: Our own classification. We were unsatisified with some of the CMS definitions and therefore created our own version with the input of medically trained clinical informaticists.

cms_chronic_conditions_long

This table contains one record per patient per chronic condition. For example, if a patient has 3 chronic conditions they will have 3 records in this table. Each record includes the condition category, condition, date of onset, most recent diagnosis, and the total count of diagnosis codes that were recorded that are relevant for the condition.

This table is created by running the CMS chronic conditions data mart on data that's been mapped to the core data model.

Primary Keys:

• patient_id
• condition

Foreign Keys:

• claim_id

Column	Data Type	Description	Terminology

cms_chronic_conditions_wide

This table contains a single record per patient with separate binary (i.e. 0 or 1) columns for every chronic condition. If a patient has a particular chronic condition they will have a 1 in that particular column and 0 otherwise.

Primary Keys:

• patient_id

Column	Data Type	Description	Terminology

tuva_chronic_conditions_long

This table contains one record per patient per chronic condition. For example, if a patient has 3 chronic conditions they will have 3 records in this table. Each record includes the condition category, condition, date of onset, most recent diagnosis, and the total count of diagnosis codes that were recorded that are relevant for the condition.

Primary Keys:

• patient_id
• condition

Column	Data Type	Description	Terminology

tuva_chronic_conditions_wide

This table contains a single record per patient with separate binary (i.e. 0 or 1) columns for every chronic condition. If a patient has a particular chronic condition they will have a 1 in that particular column and 0 otherwise.

Primary Keys:

• patient_id

Column	Data Type	Description	Terminology