Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation.
Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation.
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DOI：
10.1186/1471-2431-14-199
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发表时间：
2014-08-08
期刊：
影响因子：
2.4
通讯作者：
Dai D
中科院分区：
文献类型：
--
作者：
Feudtner C;Feinstein JA;Zhong W;Hall M;Dai D
2000年制定的儿科复杂慢性病（CCC）分类系统需要修订，以适应国际疾病分类第10次修订版（ICD-10）。为了更新CCC分类系统，我们纳入了在原始系统中遗漏或错误指定的ICD-9诊断代码，然后使用通用等效映射（GEM）在ICD-9和ICD-10之间进行翻译。我们进一步审查了ICD-9和ICD-10系统中的所有代码，以包括指示技术依赖或器官移植的诊断和程序代码。我们将临时CCC第2版（v2）系统应用于死亡证明信息和2个卫生利用数据库，审查了由此产生的CCC分类，并纠正了任何错误分类。最后，我们通过评估以下内容评价了CCC v2系统的性能：1）使用包括ICD-9代码和ICD-10代码的数据评估了系统在ICD-9和ICD-10代码之间的稳定性; 2）ICD-10实施前后的逐年稳定性; 3）在v1和v2系统中均被归类为CCC的患者比例。CCC v2分类系统由诊断和程序代码组成，其中包含新的新生儿CCC类别以及因技术依赖或器官移植而产生的复杂领域。CCC v2证明ICD-9和ICD-10之间具有密切的可比性，并且在美国没有发现死亡时间趋势的显著不连续性。与原始系统相比，CCC v2导致国家住院数据集中被确定为患有CCC的患者数量绝对增加1.0%（相对增加10%），国家急诊科数据集中被确定为患有CCC的患者数量绝对增加0.4%（相对增加24%）。更新后的CCC v2系统是全面和多层面的，并提供了必要的更新，以适应ICD-10的广泛实施。
The pediatric complex chronic conditions (CCC) classification system, developed in 2000, requires revision to accommodate the International Classification of Disease 10th Revision (ICD-10). To update the CCC classification system, we incorporated ICD-9 diagnostic codes that had been either omitted or incorrectly specified in the original system, and then translated between ICD-9 and ICD-10 using General Equivalence Mappings (GEMs). We further reviewed all codes in the ICD-9 and ICD-10 systems to include both diagnostic and procedural codes indicative of technology dependence or organ transplantation. We applied the provisional CCC version 2 (v2) system to death certificate information and 2 databases of health utilization, reviewed the resulting CCC classifications, and corrected any misclassifications. Finally, we evaluated performance of the CCC v2 system by assessing: 1) the stability of the system between ICD-9 and ICD-10 codes using data which included both ICD-9 codes and ICD-10 codes; 2) the year-to-year stability before and after ICD-10 implementation; and 3) the proportions of patients classified as having a CCC in both the v1 and v2 systems. The CCC v2 classification system consists of diagnostic and procedural codes that incorporate a new neonatal CCC category as well as domains of complexity arising from technology dependence or organ transplantation. CCC v2 demonstrated close comparability between ICD-9 and ICD-10 and did not detect significant discontinuity in temporal trends of death in the United States. Compared to the original system, CCC v2 resulted in a 1.0% absolute (10% relative) increase in the number of patients identified as having a CCC in national hospitalization dataset, and a 0.4% absolute (24% relative) increase in a national emergency department dataset. The updated CCC v2 system is comprehensive and multidimensional, and provides a necessary update to accommodate widespread implementation of ICD-10.
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影响因子：
2.4
作者：
Feudtner C;Villareale NL;Morray B;Sharp V;Hays RM;Neff JM
通讯作者：
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