识别与身体虐待相关的婴幼儿住院治疗：向 ICD-10-CM 编码过渡的影响。
Identification of physical abuse-related hospitalizations in young children: Impact of the transition to ICD-10-CM coding.
机构信息
Center for Surgical Outcomes Research and Center for Innovation in Pediatric Practice, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Dr., Columbus 43205, OH, USA.
Division of Child and Family Advocacy, Nationwide Children's Hospital, 655 E Livingston Ave, Columbus 43205, OH, USA.
出版信息
Child Abuse Negl. 2021 Aug;118:105159. doi: 10.1016/j.chiabu.2021.105159. Epub 2021 Jun 17.
BACKGROUND
Administrative healthcare databases are frequently used for child physical abuse (CPA)-related research and surveillance. In October 2015, the United States transitioned to the International Classification of Diseases, Clinical Modification-10th Revision (ICD-10-CM) coding regimen. ICD-10-CM expands coding related to CPA, including codes to differentiate suspected from confirmed CPA.
OBJECTIVE
This study examined the impact of the transition to ICD-10-CM coding on population-level trends in rates of hospitalizations coded for CPA.
PARTICIPANTS AND SETTINGS
Hospitalizations coded as related to CPA in children <5 years-of-age from 2010 to 2017 were identified across 19 Statewide Inpatient Databases.
METHODS
Interrupted time series analyses were used to assess the impact of the coding transition on hospitalizations coded for CPA, overall and by child race/ethnicity.
RESULTS
Of 9715 hospitalizations coded for CPA, 2797 (29%) occurred after the coding transition, including 51% coded for suspected CPA and 49% coded for confirmed CPA. There was a marginally-significant increase in the trend in CPA-related hospitalization after the coding transition among all children (0.09 per 100,000 children-per-quarter, p = 0.06), a significant increase in the trend among white children (0.15 per 100,000 children-per-quarter, p = 0.01), and no change among Black or Hispanic children. After the coding transition, hospitalizations coded for suspected CPA increased significantly overall (0.10 per 100,000 children-per-quarter, p < 0.001), and in particular among white children (0.12 per 100,000 children-per-quarter, p = 0.01) but not among Black or Hispanic children.
CONCLUSIONS
The transition to ICD-10-CM differentially impacted trends in hospitalizations coded for CPA by child race/ethnicity. Further research is necessary to discern the reasons for these discrepancies.
背景
行政医疗保健数据库常用于儿童身体虐待（CPA）相关研究和监测。2015 年 10 月，美国过渡到国际疾病分类，临床修正版第 10 次修订版（ICD-10-CM）编码方案。ICD-10-CM 扩展了与 CPA 相关的编码，包括区分疑似和确诊 CPA 的代码。
目的
本研究考察了向 ICD-10-CM 编码过渡对儿童 <5 岁人群中因 CPA 住院率的人群水平趋势的影响。
参与者和设置
从 2010 年至 2017 年，在 19 个全州住院数据库中确定了编码为儿童 <5 岁与 CPA 相关的住院病例。
方法
采用中断时间序列分析评估编码转换对因 CPA 住院的影响，总体上和按儿童种族/族裔进行评估。
结果
在因 CPA 编码的 9715 例住院中，2797 例（29%）发生在编码转换后，其中 51%编码为疑似 CPA，49%编码为确诊 CPA。在所有儿童中，编码转换后 CPA 相关住院的趋势略有显著增加（每 100000 名儿童每季度增加 0.09 例，p=0.06），白人儿童的趋势显著增加（每 100000 名儿童每季度增加 0.15 例，p=0.01），黑人和西班牙裔儿童无变化。在编码转换后，总体上因疑似 CPA 编码的住院显著增加（每 100000 名儿童每季度增加 0.10 例，p<0.001），尤其是白人儿童（每 100000 名儿童每季度增加 0.12 例，p=0.01），但黑人和西班牙裔儿童没有增加。
结论
向 ICD-10-CM 过渡对按儿童种族/族裔编码的 CPA 住院趋势产生了不同的影响。需要进一步研究以查明这些差异的原因。
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