科罗拉多州 ICD-10-CM 转换期间大麻编码的中断时间序列分析。

Interrupted time series analysis of cannabis coding in Colorado during the ICD-10-CM transition.

机构信息

Marijuana Health Monitoring Program, Colorado Department of Public Health and Environment, Denver, Colorado, USA.

EMS and Trauma Systems Section, Montana Department of Public Health and Human Services, Helena, Montana, USA

出版信息

Inj Prev. 2021 Mar;27(S1):i66-i70. doi: 10.1136/injuryprev-2019-043511.

DOI:10.1136/injuryprev-2019-043511

PMID:33674336

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7948183/

Abstract

The International Classification of Diseases, 10 Revision, Clinical Modification (ICD-10-CM), implemented in 2015, has more codes than ICD-9-CM for events involving cannabis. We examined cannabis indicator trends across the transition from ICD-9-CM to ICD-10-CM in Colorado, where state law regulates adult cannabis use. Using 2011 to 2018 data from hospital and emergency department (ED) discharges, we calculated monthly rates per 1000 discharges for two indicators: (1) cannabis use disorders and (2) poisoning and adverse effects of psychodysleptics. Immediate, point-of-transition (level) and gradual, post-transition (slope) changes across the ICD-9-CM to ICD-10-CM transition were tested using interrupted time series models adjusted for legalisation, seasonality and autocorrelation. We observed a level increase and slope increase in the rate of ED discharges with cannabis use disorders. Hospital discharges with cannabis use disorders had a negative slope change after the transition and no level change. ED discharges with poisoning and adverse effects of psychodysleptics showed an increase in slope after the transition. No effects of the transition were observed on hospital discharges with poisoning and adverse effects of psychodysleptics. Shifts in the level and slope of cannabis indicator rates after implementation of the new coding scheme suggest the use of caution when interpreting trends spanning the ICD-9-CM to ICD-10-CM transition.

摘要

国际疾病分类第十次修订版临床修订本（ICD-10-CM）于 2015 年实施，与 ICD-9-CM 相比，涉及大麻的事件代码更多。我们在科罗拉多州检查了从 ICD-9-CM 过渡到 ICD-10-CM 期间大麻指标的趋势，该州法律规范了成人使用大麻。利用 2011 年至 2018 年来自医院和急诊部（ED）出院的数据，我们计算了两个指标的每月每 1000 名出院者的比率：（1）大麻使用障碍，（2）精神兴奋剂中毒和不良影响。使用中断时间序列模型，调整了合法化、季节性和自相关因素，测试了从 ICD-9-CM 到 ICD-10-CM 过渡期间的即时、过渡点（水平）和渐进、过渡后（斜率）变化。我们观察到，在 ICD-9-CM 到 ICD-10-CM 过渡期间，ED 以大麻使用障碍为指征的出院率呈上升水平和斜率。大麻使用障碍的医院出院率在过渡后呈负斜率变化，无水平变化。ED 以精神兴奋剂中毒和不良影响为指征的出院率在过渡后斜率增加。在 ED 以精神兴奋剂中毒和不良影响为指征的出院率中，未观察到过渡的影响。新编码方案实施后，大麻指标率的水平和斜率变化表明，在解释跨越 ICD-9-CM 到 ICD-10-CM 过渡的趋势时应谨慎。