Impact of the ICD-9-CM to ICD-10-CM transition on the incidence of severe maternal morbidity among delivery hospitalizations in the United States
Impact of the ICD-9-CM to ICD-10-CM transition on the incidence of severe maternal morbidity among delivery hospitalizations in the United States
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DOI：
10.1016/j.ajog.2021.03.036
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发表时间：
2021-10-02
影响因子：
9.8
通讯作者：
Hetherington, Erin
中科院分区：
文献类型：
--
作者：
Metcalfe, Amy;Sheikh, Manal;Hetherington, Erin
背景技术背景：监测孕产妇死亡率和严重孕产妇发病率对于确定时间趋势、评估临床实践变化或干预措施的影响以及监测护理质量非常重要。严重孕产妇发病率监测的一个共同来源是出院数据。2015年10月1日，美国所有的医院从国际疾病分类第九修订版临床修改版过渡到国际疾病分类第十修订版临床修改版诊断和程序编码。目的：本研究旨在评价从《国际疾病分类》第九次修订版过渡到《国际疾病分类》的影响，国际疾病分类第十次修订的临床修正，美国出院数据中严重孕产妇发病率的临床修正编码系统。研究设计：使用来自全国住院患者样本的数据，使用经过验证的病例定义确定了2012年1月1日至2017年12月31日之间的产科分娩。严重孕产妇发病率使用疾病控制和预防中心提供的国际疾病分类第九版临床修订（2012年1月1日至2015年9月30日）和国际疾病分类第十版临床修订（2015年10月1日至2017年12月31日）代码定义。采用间断时间序列和分段回归分析评估从《国际疾病分类》第九版临床修订版到《国际疾病分类》第十版临床修订版编码的过渡对每1000例产科分娩中严重孕产妇发病率的影响。从22 751 941次分娩中，《国际疾病分类》第九次修订版中的严重孕产妇发病率，国际分类中，临床修改编码时代为每1000例产科分娩19.04例，降至每1000例产科分娩17.39例第十次修订，临床修改编码时代（P
BACKGROUND: Surveillance of maternal mortality and severe maternal morbidity is important to identify temporal trends, evaluate the impact of clinical practice changes or interventions, and monitor quality of care. A common source for severe maternal morbidity surveillance is hospital discharge data. On October 1, 2015, all hospitals in the United States transitioned from the International Classification of Diseases, Ninth Revision, Clinical Modification to the International Classification of Diseases, Tenth Revision, Clinical Modification coding for diagnoses and procedures.OBJECTIVE: This study aimed to evaluate the impact of the transition from the International Classification of Diseases, Ninth Revision, Clinical Modification to the International Classification of Diseases, Tenth Revision, Clinical Modification coding systems on the incidence of severe maternal morbidity in the United States in hospital discharge data.STUDY DESIGN: Using data from the National Inpatient Sample, obstetrical deliveries between January 1, 2012, and December 31, 2017, were identified using a validated case definition. Severe maternal morbidity was defined using the International Classification of Diseases, Ninth Revision, Clinical Modification (January 1, 2012, to September 30, 2015) and the International Classification of Diseases, Tenth Revision, Clinical Modification (October 1, 2015, to December 31, 2017) codes provided by the Centers for Disease Control and Prevention. An interrupted time series and segmented regression analysis was used to assess the impact of the transition from the International Classification of Diseases, Ninth Revision, Clinical Modification to the International Classification of Diseases, Tenth Revision, Clinical Modification coding on the incidence of severe maternal morbidity per 1000 obstetrical deliveries.RESULTS: From 22,751,941 deliveries, the incidence of severe maternal morbidity in the International Classification of Diseases, Ninth Revision, Clinical Modification coding era was 19.04 per 1000 obstetrical deliveries and decreased to 17.39 per 1000 obstetrical deliveries in the International Classification of Diseases, Tenth Revision, Clinical Modification coding era (P