Center for Next Generation of Community Health, Chiba University Hospital, 1-8-15 Inohana, Chuo-ku, Chiba City, Chiba 260-0856, Japan; Department of Orthopaedic Surgery, JCHO Funabashi Central Hospital, 6-13-10 Kaijin, Funabashi City, Chiba 260-8670, Japan.
Department of Pediatric Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki City, Kanagawa 216-8511 Japan.
J Orthop Sci. 2024 Mar;29(2):675-680. doi: 10.1016/j.jos.2023.01.002. Epub 2023 Feb 1.
The Japanese Orthopedic Association launched the Japanese Orthopedic Association National Registry (JOANR), Japan's first large-scale nationwide musculoskeletal disease registry, in 2020. The World Health Organization released the International Classification of Health Interventions (ICHI) Beta-3 version in the same year. This concurrence served as an impetus to examine the relationship between domestic and international classification for orthopedic interventions. Our objective was to evaluate the possibility of utilizing JOANR for international comparison and the potential usage of ICHI in the domestic medical fee reimbursement system. This study is a novel attempt at mapping a domestic orthopedic scheme to the ICHI.
We mapped 149 codes out of 581 orthopedic surgical codes, on JOANR's registration form, to the ICHI, and then classified the nature of JOANR codes' relationship, to both ICHI single stem codes and stem codes accompanied by other additional stem codes, extension codes, and International Classification of Diseases for Mortality and Morbidity Statistics (ICD) codes, into five categories: Equivalent (exact match), Narrower (compared to ICHI; can be smoothly incorporated into ICHI), Broader (compared to ICHI), Slipped (combination of both Narrower and Broader), and None (no appropriate code). Finally, debatable issues that arose during the mapping operation were noted.
The domestic codes' relationship to ICHI single stem code by category were Equivalent: 27 (18.1%) and Narrower: 65 (43.6%), respectively. Further, the rate of Equivalent rose to 120 (80.5%) on adding other stem codes, extension codes, and ICD codes. Additionally, certain domestic titles, which were unsuitable for classification as they included diagnostic information, and arthroscopic surgeries without corresponding ICHI codes, were recoded.
JOANR can be converted to an international comparison standard via ICHI to a certain extent, and ICHI accompanied by ICD codes has potential for deployment in the domestic medical fee reimbursement system.
日本矫形外科学会于 2020 年推出了日本矫形外科学会全国注册系统（JOANR），这是日本首个大规模的全国肌肉骨骼疾病注册系统。同年，世界卫生组织发布了《国际卫生干预分类》（ICHI）Beta-3 版。这一巧合促使人们研究国内和国际矫形干预分类之间的关系。我们的目标是评估使用 JOANR 进行国际比较的可能性，以及 ICHI 在国内医疗费用报销系统中的潜在用途。本研究是首次尝试将国内矫形方案映射到 ICHI 上。
我们将 JOANR 登记表上的 581 个矫形手术代码中的 149 个代码映射到 ICHI 上，然后根据 JOANR 代码与 ICHI 单一主干代码以及伴随其他附加主干代码、扩展代码和《国际疾病分类》（ICD）代码的关系，将其性质分为五类：等同（完全匹配）、更窄（与 ICHI 相比；可以顺利纳入 ICHI）、更宽、滑脱（更窄和更宽的组合）和无（无合适代码）。最后，记录了映射操作中出现的有争议的问题。
国内代码与 ICHI 单一主干代码的关系，按类别分别为等同：27（18.1%）和更窄：65（43.6%）。此外，在添加其他主干代码、扩展代码和 ICD 代码后，等同的比例上升到 120（80.5%）。此外，一些国内的标题，由于包含诊断信息，以及没有相应 ICHI 代码的关节镜手术，不适合分类，因此进行了重新编码。
JOANR 可以通过 ICHI 在一定程度上转化为国际比较标准，而伴有 ICD 代码的 ICHI 有可能在国内医疗费用报销系统中使用。
