International variation in the definition of 'main condition' in ICD-coded health data
International variation in the definition of 'main condition' in ICD-coded health data
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DOI：
10.1093/intqhc/mzu064
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发表时间：
2014-10-01
影响因子：
2.6
通讯作者：
Ghali, W. A.
中科院分区：
文献类型：
--
作者：
Quan, H.;Moskal, L.;Ghali, W. A.
在许多国家，基于医院的医疗记录被提取以创建国际疾病分类（ICD）编码的出院健康数据。国际上对“主要条件”的定义并不一致。有些国家采用“接纳理由”规则作为主要条件的基础，而另一些国家则采用“资源使用”规则。一些国家最近已从其中一种办法过渡到另一种办法。当ICD数据中的“主要疾病”定义用于定义疾病队列以分配诊断相关组和进行风险调整时，它很重要。我们提出了一种协调国际定义的方法，使研究人员和国际组织能够使用ICD编码的健康数据，以一致的方式汇总或比较各国的医院护理和结果。在最后确定定义并在全世界采用之前，应评估其他协调办法在观察员之间的可靠性。
Hospital-based medical records are abstracted to create International Classification of Disease (ICD) coded discharge health data in many countries. The 'main condition' is not defined in a consistent manner internationally. Some countries employ a 'reason for admission' rule as the basis for the main condition, while other countries employ a 'resource use' rule. A few countries have recently transitioned from one of these approaches to the other. The definition of 'main condition' in such ICD data matters when it is used to define a disease cohort to assign diagnosis-related groups and to perform risk adjustment. We propose a method of harmonizing the international definition to enable researchers and international organizations using ICD-coded health data to aggregate or compare hospital care and outcomes across countries in a consistent manner. Inter-observer reliability of alternative harmonization approaches should be evaluated before finalizing the definition and adopting it worldwide.