Trends in delivery hospitalizations and the impact of ICD-9-CM to ICD-10-CM-PCS transition in Portugal between 2010 and 2018

Q1 Medicine

Informatics in Medicine Unlocked Pub Date : 2025-01-01 DOI:10.1016/j.imu.2025.101626

Catarina de Paraíso Camarinha , Maria Miguel Gomes Oliveira , Cecília Elias , Miguel de Araújo Nobre , Leonor Bacelar Costa Nicolau , Cristina Furtado , Andreia Silva da Costa , Paulo Jorge da Silva Nogueira

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引用次数: 0

Abstract

Background

Hospital discharge data are essential for maternal health surveillance, clinical research, and healthcare resource allocation. In 2017, Portuguese hospitals transitioned from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to the International Classification of Diseases, 10th edition, Clinical Modification and Procedure Coding System (ICD-10-CM/PCS), impacting the recording of delivery hospitalizations. This study examines trends in delivery hospitalizations from 2010 to 2018 and assesses the impact of the ICD-10-CM/PCS transition.

Methods

We conducted a register-based observational cross-sectional analysis using data from the National Hospital Discharge Database, covering delivery hospitalizations in public hospitals from January 1, 2010, to December 31, 2018. Delivery episodes were identified using diagnosis codes, normal delivery codes, diagnosis-related group (DRG) codes, and procedure codes. Statistical analyses included descriptive statistics, interrupted time series with segmented regression, and Prophet forecasting models to evaluate trends and the impact of the coding transition.

Results

A total of 673,978 delivery hospitalizations were recorded. The transition from ICD-9-CM to ICD-10-CM/PCS in 2017 had minimal overall impact on delivery trends. DRG codes consistently identified the majority of delivery episodes, with outcome of delivery codes and selected procedure codes showing varying trends. An increase in episodes identified by normal delivery codes and a significant decrease in episodes identified by procedure codes was observed immediately after the ICD-10 transition (p < 0.001). The Prophet model indicated improved forecast accuracy for procedure codes when including the ICD-10 transition variable.

Conclusion

The transition to ICD-10-CM/PCS had a limited impact on overall delivery hospitalization trends but significantly affected procedure coding. These findings underscore the importance of considering coding system changes in healthcare data analyses. Further research should incorporate private hospital data and continuously monitor coding practices to ensure reliable health data for research and policy-making.

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2010年至2018年葡萄牙分娩住院趋势及ICD-9-CM向ICD-10-CM-PCS过渡的影响

出院数据对孕产妇健康监测、临床研究和医疗资源分配至关重要。2017年，葡萄牙医院从国际疾病分类第九版临床修改（ICD-9-CM）过渡到国际疾病分类第十版临床修改和程序编码系统（ICD-10-CM/PCS），影响了分娩住院记录。本研究调查了2010年至2018年分娩住院的趋势，并评估了ICD-10-CM/PCS过渡的影响。方法利用全国医院出院数据库2010年1月1日至2018年12月31日公立医院分娩住院数据，进行基于登记的观察性横断面分析。使用诊断代码、正常分娩代码、诊断相关组（DRG）代码和程序代码识别分娩事件。统计分析包括描述性统计、分段回归的中断时间序列和Prophet预测模型，以评估趋势和编码转换的影响。结果共记录分娩住院673978例。2017年从ICD-9-CM向ICD-10-CM/PCS的过渡对分娩趋势的总体影响很小。DRG代码一致地确定了大多数交付事件，交付结果代码和选定的程序代码显示出不同的趋势。在ICD-10转换后，立即观察到正常分娩代码确定的发作增加，程序代码确定的发作显著减少(p <；0.001)。Prophet模型表明，当包含ICD-10转换变量时，程序代码的预测精度得到了提高。结论向ICD-10-CM/PCS过渡对整体分娩住院趋势影响有限，但对程序编码影响显著。这些发现强调了在医疗数据分析中考虑编码系统变化的重要性。进一步的研究应纳入私立医院的数据，并不断监测编码做法，以确保可靠的健康数据用于研究和决策。

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

Informatics in Medicine Unlocked Medicine-Health Informatics

CiteScore

9.50

自引率

0.00%

发文量

282

审稿时长

39 days

期刊介绍： Informatics in Medicine Unlocked (IMU) is an international gold open access journal covering a broad spectrum of topics within medical informatics, including (but not limited to) papers focusing on imaging, pathology, teledermatology, public health, ophthalmological, nursing and translational medicine informatics. The full papers that are published in the journal are accessible to all who visit the website.