Watzlaf Valerie J M, Garvin Jennifer Hornung, Moeini Sohrab, Anania-Firouzan Patricia
School of Health and Rehabilitation Sciences at the University of Pittsburgh in Pittsburgh, PA, USA.
Perspect Health Inf Manag. 2007 Jun 12;4:6.
This research study examined the usefulness of the ICD-10-CM system in capturing public health diseases (reportable diseases or the nationally notifiable infectious diseases, leading causes of death, and morbidity/mortality related to terrorism), when compared to ICD-9-CM.1-3 It also examined agreement levels of coders when coding public health diseases in both ICD-10-CM and ICD-9-CM. Overall results demonstrate that ICD-10-CM is more specific and fully captures more of the public health diseases examined than ICD-9-CM. In the analysis of all the public health diseases, such as reportable diseases (p<0.001), top 10 causes of death (p<0.001), and those related to terrorism (p<0.001), it was found that the overall rankings for disease capture for ICD-10-CM were significantly higher than the rankings for ICD-9-CM. When examining whether diseases were captured more straightforwardly and clearly (regarding agreement levels) between coding systems, statistically significant differences were found for external causes of injury (p<0.001), diabetes (average rank only, p<0.05), lower respiratory disease (p<0.001), heart disease (p<0.001), and malignant neoplasms (p<0.05). Although this result may be due to the coder's higher level of experience with ICD-9-CM, it also points to the potential need for more specific coding education and practice with the ICD-10-CM system.
本研究调查了与ICD-9-CM相比,ICD-10-CM系统在记录公共卫生疾病(应报告疾病或国家法定传染病、主要死因以及与恐怖主义相关的发病率/死亡率)方面的效用。1-3它还调查了编码人员在使用ICD-10-CM和ICD-9-CM对公共卫生疾病进行编码时的一致性水平。总体结果表明,与ICD-9-CM相比,ICD-10-CM更具特异性,能够更全面地记录所调查的公共卫生疾病。在对所有公共卫生疾病进行分析时,如应报告疾病(p<0.001)、十大死因(p<0.001)以及与恐怖主义相关的疾病(p<0.001),发现ICD-10-CM在疾病记录方面的总体排名显著高于ICD-9-CM。在检查编码系统之间疾病记录是否更直接、更清晰(关于一致性水平)时,发现伤害外部原因(p<0.001)、糖尿病(仅平均排名,p<0.05)、下呼吸道疾病(p<0.001)、心脏病(p<0.001)和恶性肿瘤(p<0.05)存在统计学显著差异。尽管这一结果可能是由于编码人员对ICD-9-CM的经验更丰富,但这也表明可能需要对ICD-10-CM系统进行更具体的编码教育和实践。