Trends in Opioid-related Inpatient Stays Shifted After the US Transitioned to ICD-10-CM Diagnosis Coding in 2015
Trends in Opioid-related Inpatient Stays Shifted After the US Transitioned to ICD-10-CM Diagnosis Coding in 2015
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DOI：
10.1097/mlr.0000000000000805
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发表时间：
2017-11-01
期刊：
影响因子：
3
通讯作者：
Elixhauser, Anne
中科院分区：
文献类型：
--
作者：
Heslin, Kevin C.;Owens, Pamela L.;Elixhauser, Anne
背景：阿片类药物相关住院时间的趋势分析取决于一段时间内可比数据的可用性。 2015年10月，美国将诊断编码从国际疾病分类第九版临床修订版（ICD-9-CM）转变为ICD-10-CM，编码从大约14,000个增加到68,000个。本研究探讨了向 ICD-10-CM 过渡对涉及阿片类药物诊断的住院患者住院时间的趋势分析有何影响。 受试者：数据来自 2015 年至 2016 年 14 个州的医疗保健成本和利用项目州住院患者数据库，占美国急症护理住院患者出院人数的 26%。 研究设计：我们研究了过渡到 ICD-10-CM 之前、期间和之后与阿片类药物相关的住院人数的变化ICD-10-CM 使用 2015 年季度 ICD-9-CM 数据以及 2015 年第四季度和 2016 年前 3 季度的季度 ICD-10-CM 数据。结果：总体而言，在 ICD 过渡期间，涉及任何阿片类药物相关诊断的停留时间增加了 14.1%，在此之前，过渡前的平均季度增长率要低得多，为 5.0%，随后平均增加 3.5%过渡后。在分层分析中，过渡期间涉及阿片类药物治疗使用不良反应的停留时间增幅最大（63.2%），而涉及滥用和中毒诊断的停留时间分别减少了 21.1% 和 12.4%。 结论：在向 ICD-10-CM 过渡期间，阿片类药物相关停留时间总体急剧增加，可能表明新的分类系统正在捕获 ICD-9-CM 数据遗漏的停留时间。涉及其他诊断的住院时间估计也可能受到影响，分析师应评估 ICD 过渡过程中趋势的潜在不连续性。
Background: Trend analyses of opioid-related inpatient stays depend on the availability of comparable data over time. In October 2015, the US transitioned diagnosis coding from International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to ICD-10-CM, increasing from similar to 14,000 to 68,000 codes. This study examines how trend analyses of inpatient stays involving opioid diagnoses were affected by the transition to ICD-10-CM.Subjects: Data are from Healthcare Cost and Utilization Project State Inpatient Databases for 14 states in 2015-2016, representing 26% of acute care inpatient discharges in the US.Study Design: We examined changes in the number of opioid-related stays before, during, and after the transition to ICD-10-CM using quarterly ICD-9-CM data from 2015 and quarterly ICD-10-CM data from the fourth quarter of 2015 and the first 3 quarters of 2016.Results: Overall, stays involving any opioid-related diagnosis increased by 14.1% during the ICD transition-which was preceded by a much lower 5.0% average quarterly increase before the transition and followed by a 3.5% average increase after the transition. In stratified analysis, stays involving adverse effects of opioids in therapeutic use showed the largest increase (63.2%) during the transition, whereas stays involving abuse and poisoning diagnoses decreased by 21.1% and 12.4%, respectively.Conclusions: The sharp increase in opioid-related stays overall during the transition to ICD-10-CM may indicate that the new classification system is capturing stays that were missed by ICD-9-CM data. Estimates of stays involving other diagnoses may also be affected, and analysts should assess potential discontinuities in trends across the ICD transition.