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Multiple Chronic Conditions, Frailty, and Mobility/Functional Impairment
in Older Adults with Heart Failure (MCC-HF) Study
Atria Project


Alan S. Go, MD, Principal Investigator Kaiser Permanente Northern California
Heather Allore, PhD, Co-Investigator University of Massachusetts Medical School
Jerry Gurwitz, MD, Co-Investigator Meyers Primary Care Institute
Mayra Tisminetzky, MD, PhD, Co-Investigator University of Massachusetts Medical School
Robert Goldberg, PhD, Co-Investigator University of Massachusetts Medical School
Terrence Murphy, PhD, Co-Investigator University of Massachusetts Medical School

Study Summary

The CVRN MCC-HF dataset is comprised of patients with diagnosed heart failure (HF) and had an assessment of left ventricular systolic function within ±2 years of HF diagnosis date. Patients were included in the MCC-HF cohort between January 1, 2005 through December 31, 2012. MCC-HF members were further stratified by co-morbid conditions using ICD-9 diagnosis codes. The MCC-HF dataset is comprised of patient data from five participating health plans: Kaiser Permanente Northern California, Kaiser Permanente Colorado, Kaiser Permanente Northwest, Kaiser Permanente Southern California, and Fallon Health-Reliant Medical Group. The Dataset was comprised using standardized programs that convert local source data-extract into a common dataset structure with the same mapped variables.


The MCC-HF dataset is comprised of patients with diagnoses HF and with an assessment of left ventricular systolic function. Diagnosed HF is defined as:

  • 1 primary discharge diagnosis of HF, or
  • 3  ambulatory visits coded for HF with at least one visit being to a cardiologist during the study period.

A total of 114,553 members were included in the cohort. The mean age of HF diagnosis was 73.3 years and 45.9% were women.

Figure 1. MCC-HF Study Dataset Age Distribution

Cohort Characteristics

Figure 2. Distribution of Comorbidities in MCC-HF Dataset

Data Source

All member data was extracted using the Virtual Data Warehouse (VDW). The VDW is a standardized resource comprised of: (1) computerized datasets stored behind separate security firewalls, including variables with identical names, formats, and specifications; (2) informatics tools that facilitate storage, retrieval, processing, and managing the datasets; and (3) detailed data documentation. All data are linked by a unique identifier so that data elements can be rolled up to the individual person-level. 

Key Publications

Gurwitz, J. H., Magid, D. J., Smith, D. H., Tabada, G. H., Sung, S. H., Allen, L. A., ... & Go, A. S. (2017). Treatment effectiveness in heart failure with comorbidity: lung disease and kidney disease. Journal of the American Geriatrics Society65(12), 2610-2618.