A refined ICD-10 diagnoses-based approach for retrospective analysis of potential palliative care need and coverage in claims data of deceased.

IF 2.3 Q2 MEDICINE, GENERAL & INTERNAL
SAGE Open Medicine Pub Date : 2024-08-13 eCollection Date: 2024-01-01 DOI:10.1177/20503121241269599
Ekaterina Slotina, Bianka Ditscheid, Franziska Meissner, Ursula Marschall, Ulrich Wedding, Antje Freytag
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Abstract

Objectives: ICD-10-based approaches often provide the basis for retrospective estimation of potential palliative care need. Applying the ICD-10-based Murtagh et al. classification from 2014 (Murtagh classification), developed using mortality data, to administrative claims data leads to inconsistencies in estimating palliative care need. The aim of the study was to refine the classification for palliative care need estimation in deceased individuals with cancer and non-cancer diagnosis.

Methods: A retrospective population-based study comparing Murtagh classification to a new ICD-10-based classification (revised by expert opinion) was conducted using outpatient and inpatient claims data, including billing codes for palliative care. Palliative care need was estimated for diagnoses groups and was contrasted with palliative care utilization rates in the last year of life. Our dataset included records of 417,405 individuals who deceased in 2016-2019.

Results: Out of individuals deceased in 2019 (n = 117,436), 81.4% had at least one diagnosis from the new classification, while 97.0% had at least one diagnosis from the Murtagh classification. Classification revision thus identified fewer individuals as potentially in need of palliative care. Among individuals with cancer, 70.7% (vs. 55.7% via Murtagh classification) received palliative care. In non-cancer subgroups, the utilization rate was considerably lower, with a maximum of 36.7% (vs. 33.7% via Murtagh classification) in 2019. Similar results were observed for the other years.

Conclusion: Compared to the ICD10-based Murtagh classification, the revised ICD-10-based classification enables more realistic estimations if the cause of death is unavailable and reveals higher rates of palliative care coverage and differences especially in cancer versus non-cancer diseases. German Clinical Trials Register (DRKS00024133).

基于 ICD-10 诊断的改进方法,用于回顾性分析死者理赔数据中潜在的姑息关怀需求和覆盖范围。
目的:基于ICD-10的方法通常是对潜在姑息关怀需求进行回顾性估算的基础。将基于 ICD-10 的 Murtagh 等人 2014 年的分类法(Murtagh 分类法)应用于行政报销数据,会导致姑息关怀需求估算的不一致性。本研究旨在完善该分类,以估算已故癌症和非癌症患者的姑息关怀需求:一项基于人群的回顾性研究利用门诊和住院病人的报销数据,包括姑息关怀的计费代码,比较了 Murtagh 分类法和基于 ICD-10 的新分类法(根据专家意见修订)。对各诊断组的姑息关怀需求进行了估算,并与生命最后一年的姑息关怀使用率进行了对比。我们的数据集包括2016-2019年死亡的417405人的记录:在2019年去世的患者中(n = 117,436),81.4%的患者至少有一项诊断来自新分类,而97.0%的患者至少有一项诊断来自穆塔格分类。因此,分类修订后发现可能需要姑息关怀的人数减少了。在癌症患者中,70.7%的人接受了姑息治疗(与穆塔格分类中的 55.7%相比)。在非癌症亚组中,使用率要低得多,2019 年的最高使用率为 36.7%(根据 Murtagh 分类法为 33.7%)。其他年份也观察到类似的结果:与基于 ICD10 的 Murtagh 分类法相比,基于 ICD-10 的修订版分类法在无法获得死因的情况下能够进行更真实的估算,并揭示出更高的姑息治疗覆盖率,特别是在癌症与非癌症疾病中的差异。德国临床试验登记(DRKS00024133)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
SAGE Open Medicine
SAGE Open Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
4.30%
发文量
289
审稿时长
12 weeks
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