Comparison and validity of procedures coded with ICD-9-CM and ICD-10-CA/CCI
Comparison and validity of procedures coded with ICD-9-CM and ICD-10-CA/CCI
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DOI：
10.1097/mlr.0b013e3181649439
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发表时间：
2008-06-01
期刊：
影响因子：
3
通讯作者：
Quan, Hude
中科院分区：
文献类型：
--
作者：
De Coster, Carolyn;Li, Bing;Quan, Hude
背景资料：标准化的分类系统，如国际疾病分类（ICD），促进了卫生行政数据在卫生服务研究中的使用。除其他国家外，加拿大最近采用了《国际疾病分类》第十版及其配套的《加拿大干预措施分类》。这是必要的，以评估错误，可能会发生在行政数据，由于引入新的编码system.Objective：评估程序编码的有效性，在医院出院数据，比较CCI与ICD-9-CM.Research Design：训练有素的审查员检查4008随机选择的图表从4所教学医院在加拿大阿尔伯塔，为30个程序的存在。已经使用CCI编码的图表使用ICD-9-CM重新编码。在这两个系统中的程序代码的综合清单，确定使用文献，健康记录技术人员，外科医生和在线resources.Measures：三个数据库创建了相同的医院出院记录，包括CCI，ICD-9-CM，和图表审查数据。结果：ICD-9-CM数据与病历回顾数据相比，少报17例，多报12例，等效报告1例。CCI数据少报19例手术，多报9例，等效报告2例。ICD-9-CM和CCI之间的Kappa值在0.1以内的差异为14 procedures.Conclusions：ICD-9-CM和CCI编码更主要或侵入性的程序合理，但不适用于侵入性较低或较小的程序。CCI可以被卫生服务和人口健康研究人员使用，与ICD-9-CM一样有信心。
Background: The use of health administrative data in health services research is facilitated by standardized classification systems, such as the International Classification of Diseases (ICD). Canada, among other countries, recently introduced the tenth version of ICD and its accompanying Canadian Classification of Interventions (CCI). It is imperative to assess errors that could occur in administrative data due to the introduction of the new coding system.Objective: To evaluate the validity of procedure coding in hospital discharge data, comparing CCI with ICD-9-CM.Research Design: Trained reviewers examined 4008 randomly selected charts from 4 teaching hospitals in Alberta, Canada, for the presence of 30 procedures. The charts, already coded using CCI, were recoded using ICD-9-CM. Comprehensive lists of procedure codes in both systems were identified using literature, health records technicians, surgeons and online resources.Measures: Three databases were created for the same hospital discharge record, including CCI, ICD-9-CM, and chart review data. Sensitivity, specificity, positive predictive value, negative predictive value and kappa scores were calculated.Results: Compared with the chart review data, ICD-9-CM data under-reported 17 procedures, over-reported 12, and equivalently reported 1. CCI data under-reported 19 procedures, over-reported 9, and equivalently reported 2. Kappa value was within 0.1 difference between ICD-9-CM and CCI for 14 procedures.Conclusions: Both ICD-9-CM and CCI coded the more major or invasive procedures reasonably well, but were not valid for less invasive or minor procedures. CCI can be used by health services and population health researchers with as much confidence as ICD-9-CM.