The Development, Evolution, and Modifications of ICD-10 Challenges to the International Comparability of Morbidity Data
The Development, Evolution, and Modifications of ICD-10 Challenges to the International Comparability of Morbidity Data
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DOI：
10.1097/mlr.0b013e3181ef9d3e
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发表时间：
2010-12-01
期刊：
影响因子：
3
通讯作者：
Ghali, William A.
中科院分区：
文献类型：
--
作者：
Jette, Nathalie;Quan, Hude;Ghali, William A.
背景：美国即将在全国范围内进行从出院编码 ICD-9-CM 到 ICD-10-CM 的重大过渡，ICD-10-CM 是世界卫生组织 ICD-10 的针对特定国家的修改。随着这一转变的发生，世界卫生组织已经开始制定 ICD-11。鉴于这种背景，我们进行这次回顾是为了讨论：(1) 国际疾病分类（各地卫生系统的核心信息“构建块”）从引入到当前 ICD-11 开发的历史； (2) 不同国家 ICD-10 临床修改之间的差异以及这些差异对发病率数据的国际可比性带来的挑战； (3) 实现更好的 ICD-11 国际可比性的潜在战略方法。文献综述和讨论：进行了文献综述和利益相关者咨询。对各种 ICD-10 临床修改（ICD-10-AM [澳大利亚]、ICD-10-CA [加拿大]、ICD-10-GM [德国]、ICD-10-TM [泰国]、ICD-10-CM [美国]）进行了比较。这些 ICD-10 修改在代码、章节和子类别的数量上有所不同。某些但不是全部修改中存在特定条件。 ICD-11 与 ICD-10 结构相似，将在电子健康记录环境中发挥作用，并提供疾病描述特征（例如因果特性、功能影响和治疗）。 结论：随着许多国家特定 ICD-10 版本的开发，对国际临床发病率可比性的威胁日益加大。应对这一威胁的一个解决方案是开发一个元数据库，其中包括所有特定于国家/地区的修改，以确保更有效地利用人员和资源，减少遗漏和错误，但最重要的是为未来的 ICD 更新提供一个平台。
Background: The United States is about to make a major nation-wide transition from ICD-9-CM coding of hospital discharges to ICD-10-CM, a country-specific modification of the World Health Organization's ICD-10. As this transition occurs, the WHO is already in the midst of developing ICD-11. Given this context, we undertook this review to discuss: (1) the history of the International Classification of Diseases (a core information "building block" for health systems everywhere) from its introduction to the current era of ICD-11 development; (2) differences across country-specific ICD-10 clinical modifications and the challenges that these differences pose to the international comparability of morbidity data; (3) potential strategic approaches to achieving better international ICD-11 comparability.Literature Review and Discussion: A literature review and stake-holder consultation was carried out. The various ICD-10 clinical modifications (ICD-10-AM [Australia], ICD-10-CA [Canada], ICD-10-GM [Germany], ICD-10-TM [Thailand], ICD-10-CM [United States]) were compared. These ICD-10 modifications differ in their number of codes, chapters, and subcategories. Specific conditions are present in some but not all of the modifications. ICD-11, with a similar structure to ICD-10, will function in an electronic health records environment and also provide disease descriptive characteristics (eg, causal properties, functional impact, and treatment).Conclusion: The threat to the comparability of international clinical morbidity is growing with the development of many country-specific ICD-10 versions. One solution to this threat is to develop a meta-database including all country-specific modifications to ensure more efficient use of people and resources, decrease omissions and errors but most importantly provide a platform for future ICD updates.