Vikström Anna, Nyström Mikael, Ahlfeldt Hans, Strender Lars-Erik, Nilsson Gunnar H
Department of Neurobiology, Care Sciences and Society, Center for Family and Community Medicine, Karolinska Institutet, Huddinge, Sweden.
Inform Prim Care. 2010;18(1):17-29. doi: 10.14236/jhi.v18i1.750.
Primary care (PC) in Sweden provides ambulatory and home health care outside hospitals. Within the County Council of Stockholm, coding of diagnoses in PC is mandatory and is done by general practitioners (GPs) using a Swedish primary care version of the International Statistical Classification of Diseases, version 10 (ICD-10). ICD-10 has a mono-hierarchical structure. SNOMED CT is poly-hierarchical and belongs to a new generation of terminology systems with attributes (characteristics) that connect concepts in SNOMED CT and build relationships. Mapping terminologies and classifications has been pointed out as a way to attain additional advantages in describing and documenting healthcare data. A poly-hierarchical system supports the representation and aggregation of healthcare data on the basis of specific medical aspects and various levels of clinical detail.
To describe and compare diagnoses and health problems in KSH97-P/ICD-10 and SNOMED CT using primary care diagnostic data, and to explore and exemplify complementary aggregations of diagnoses and health problems generated from a mapping to SNOMED CT.
We used diagnostic data collected throughout 2006 and coded in electronic patient records (EPRs), and a mapping from KSH97-P/ICD-10 to SNOMED CT, to aggregate the diagnostic data with SNOMED CT defining hierarchical relationship Is a and selected attribute relationships.
The chapter level comparison between ICD-10 and SNOMED CT showed minor differences except for infectious and digestive system disorders. The relationships chosen aggregated the diagnostic data to 2861 concepts, showing a multidimensional view on different medical and specific levels and also including clinically relevant characteristics through attribute relationships.
SNOMED CT provides a different view of diagnoses and health problems on a chapter level, and adds significant new views of the clinical data with aggregations generated from SNOMED CT Is a and attribute relationships. A broader use of SNOMED CT is therefore of importance when describing and developing primary care.
瑞典的初级保健（PC）提供医院以外的门诊和家庭医疗服务。在斯德哥尔摩郡议会辖区内，初级保健中的诊断编码是强制性的，由全科医生（GP）使用国际疾病分类第10版（ICD - 10）的瑞典初级保健版本进行编码。ICD - 10具有单层次结构。SNOMED CT是多层次结构，属于新一代术语系统，具有将SNOMED CT中的概念联系起来并建立关系的属性（特征）。映射术语和分类被认为是在描述和记录医疗保健数据方面获得额外优势的一种方式。多层次系统支持基于特定医学方面和不同临床细节水平来表示和汇总医疗保健数据。
使用初级保健诊断数据描述和比较KSH97 - P/ICD - 10与SNOMED CT中的诊断和健康问题，并探索和举例说明从映射到SNOMED CT生成的诊断和健康问题的互补汇总。
我们使用了2006年全年收集并编码在电子病历（EPR）中的诊断数据，以及从KSH97 - P/ICD - 10到SNOMED CT的映射，以通过定义层次关系“Is a”和选定属性关系的SNOMED CT汇总诊断数据。
ICD - 10与SNOMED CT之间的章节级别比较显示，除了传染病和消化系统疾病外，差异较小。所选关系将诊断数据汇总为2861个概念，显示了不同医学和特定水平的多维视图，并且还通过属性关系包括了临床相关特征。
SNOMED CT在章节级别上提供了关于诊断和健康问题的不同视图，并通过SNOMED CT的“Is a”和属性关系生成的汇总为临床数据增添了重要的新视图。因此，在描述和发展初级保健时，更广泛地使用SNOMED CT非常重要。
