Use of International Classification of Diseases, Ninth Revision, Clinical Modification, codes to identify inpatient fall-related injuries.
Use of International Classification of Diseases, Ninth Revision, Clinical Modification, codes to identify inpatient fall-related injuries.
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使用国际疾病分类第九版临床修订代码来识别住院患者跌倒相关伤害。
DOI：
10.1111/jgs.12539
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发表时间：
2013
影响因子：
6.3
通讯作者：
Shorr,RonaldI
中科院分区：
文献类型：
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作者：
Waters,TeresaM;Chandler,AMichelle;Mion,LorraineC;Daniels,MichaelJ;Kessler,LoriA;Miller,StephenT;Shorr,RonaldI
目的 将跌倒评估员或医院事故报告中确定的跌倒和跌倒相关伤害与根据出院国际疾病分类第九版临床修订版 (ICD-9-CM) 代码确定的同一组住院护理事件的跌倒和跌倒相关伤害进行比较。设计前瞻性、描述性研究。在主要城市教学区设置 16 个成人普通医疗和外科单位 参与者 5 年内跌倒受伤的所有成年人（380 次跌倒受伤）。测量 跌倒评估员或医院事故报告确定的跌倒根据受伤严重程度进行分类。出院摘要提供了出院诊断代码 (ICD-9-CM)，包括跌倒相关伤害代码。 结果 343 例住院患者跌倒受伤 (90.2%) 导致个人暂时伤害；其余 37 起跌倒（9.8%）造成了更严重的伤害。使用医疗保险和医疗补助服务中心 (CMS) 目标伤害代码范围并结合入院时的指标，确定了 37 例因跌倒导致住院时间延长或导致死亡的 16 例。在 21 起未识别的跌倒受伤中，9 起 (42.9%) 缺乏任何受伤记录，7 起 (33.3%) 发现了 CMS 目标伤害代码范围之外的其他伤害。结论 用于识别索赔数据中跌倒相关伤害的 CMS 目标 ICD-9-CM 代码并不总是能检测到最严重的跌倒。
ObjectivesTo compare falls and fall‐related injuries that a fall evaluator or hospital incident report identified with injuries identified according to dischargeInternational Classification of Diseases, Ninth Revision, Clinical Modification(ICD‐9‐CM) codes for the same set of inpatient episodes of care.DesignProspective, descriptive study.SettingSixteen adult general medical and surgical units in a major urban teaching hospital.ParticipantsAll adults who sustained a fall with injury during a 5‐year period (380 falls with injury).MeasurementsFalls that a fall evaluator or hospital incident report identified were classified according to their injury severity. Discharge abstracts provided diagnosis codes (ICD‐9‐CM) for the discharge, including fall‐related injury codes.ResultsThree hundred forty‐three inpatient falls with injury (90.2%) resulted in temporary harm to the individual; the remaining 37 falls (9.8%) resulted in more‐serious harm. Sixteen of the 37 falls with injury extending hospitalization or resulting in death were identified using Centers for Medicare and Medicaid Services (CMS)‐targeted injury code ranges combined with present‐on‐admission indicators. Of the 21 falls with injury that were not identified, nine (42.9%) lacked documentation of any injury, and seven (33.3%) identified other injuries outside the CMS‐targeted injury code ranges.ConclusionThe CMS‐targeted ICD‐9‐CM codes used to identify fall‐related injuries in claims data do not always detect the most‐serious falls.