Prediction models that identify populations at risk for high health expenditures can guide the management and allocation of financial resources. Therefore, Desalvo and coworkers compared the ability for identifying individuals at risk for high health expenditures between the single-item assessment of general self-rated health (GSRH), "In general, would you say your health is Excellent, Very Good, Good, Fair, or Poor?," and 3 more complex measures. The investigators used data from a prospective cohort, representative of the US civilian noninstitutionalized population, to compare the predictive ability of GSRH to: (1) the Short Form-12; (2) the Seattle Index of Comorbidity; and (3) the Diagnostic Cost-Related Groups/Hierarchal Condition Categories Relative-Risk Score. The outcomes were total, pharmacy, and office-based annualized expenditures in the top quintile, decile, fifth percentile, and any inpatient expenditures. Data were gathered Medical Expenditure Panel Survey panels 8 (2003-2004, n = 7948) and 9 (2004-2005, n = 7921). The GSRH model predicted the top quintile of expenditures, as well as the SF-12, Seattle Index of Comorbidity, though not as well as the Diagnostic Cost-Related Groups/Hierarchal Condition Categories Relative-Risk Score, with respect to total expenditures, pharmacy expenditures, office-based expenditures, and any hospital inpatient expenditures. Results were similar for the decile and fifth percentile expenditure cut-points.

WHAT THIS STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that a simple model of GSRH and age robustly stratifies populations and predicts future health expenditures generally as well as more complex models. This suggests that the GSRH might provide a good outcome measure for future self-management studies.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: The single question may provide you a way to consistently monitor a chronic condition. If you plot your data over time, you might be able to determine if a particular intervention is working for you. This information, in turn, could be discussed with your health care provider.

KB Desalvo et al. Health Care Expenditure Prediction With a Single Item, Self-Rated Health Measure. Medical Care, February 20, 2009.