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Related Experiment Videos

Diagnosis clusters for emergency medicine.

Debbie A Travers1, Stephanie W Haas, Anna E Waller

  • 1Department of Emergency Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC 27599-7594, USA. dtravers@med.unc.edu

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
|December 4, 2003
PubMed
Summary

Evaluating International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code systems for emergency medicine found the Agency for Healthcare Research and Quality (AHRQ) system offered the best coverage. However, most AHRQ clusters were small.

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Area of Science:

  • Emergency Medicine
  • Health Informatics
  • Public Health Surveillance

Background:

  • Aggregated emergency department (ED) data are crucial for research, operations, and public health.
  • The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) contains over 24,000 codes, necessitating standardized groupings.
  • Existing ICD-9-CM code clusters from family medicine, internal medicine, inpatient care (AHRQ), and vital statistics (NCHS) exist.

Purpose of the Study:

  • To evaluate the coverage of four existing ICD-9-CM code cluster systems for emergency medicine applications.
  • To determine the suitability of different ICD-9-CM code grouping systems for emergency department data analysis.

Main Methods:

  • A descriptive study analyzed ICD-9-CM final diagnosis data from a tertiary referral center's ED visits in July 2000 and January 2001.

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  • Four ICD-9-CM cluster systems (AHRQ, NCHS, FM, IM) were used to group diagnosis codes.
  • Coverage was defined as the proportion of diagnosis codes included in clusters, and cluster frequencies were analyzed.

    • Main Results:

    • The study included 7,543 ED visits with 19,530 diagnoses.
    • Coverage varied by system: AHRQ (99%), NCHS (88%), FM (71%), and IM (68%).
    • Seventy-six percent of AHRQ clusters contained less than 1% of the total diagnosis codes.

    Conclusions:

    • The AHRQ system demonstrated the highest coverage for emergency department ICD-9-CM codes.
    • Despite high coverage, the majority of AHRQ clusters were small and not significantly distinct from raw data.
    • Further refinement of ICD-9-CM clustering may be needed for optimal emergency medicine data utilization.