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The impact of changing ICD code on hypertension-related mortality in the southeastern United States from 1994-2005

JaNae Joyner-Grantham1, Debra R Simmons, Michael A Moore

  • 1Consortium for Southeastern Hypertension Control (COSEHC) and Wake Forest University Hypertension and Vascular Research Center, Winston Salem, NC 27113-5097, USA. jjoyner@wfubmc.edu

Journal of Clinical Hypertension (Greenwich, Conn.)
|May 4, 2010
PubMed

Insights

International Classification of Diseases (ICD) code revisions impact cardiovascular disease mortality trends. The ICD-10 change in 1999 affected heart disease, cerebrovascular disease, and diabetes rates in the Southeast US.

Area of Science:

  • Public Health
  • Epidemiology
  • Health Informatics

Background:

  • Cardiovascular disease (CVD) trend analysis is complicated by revisions in disease classification systems like the International Classification of Diseases (ICD).
  • Accurate mortality data is crucial for understanding disease burden and informing public health strategies.

Purpose of the Study:

  • To examine the impact of International Classification of Diseases (ICD) code revision on mortality trends for heart disease, cerebrovascular disease, and diabetes in 16 Southeast states.
  • To assess whether the ICD code change in 1999 influenced the observed mortality trends in the specified population.

Main Methods:

  • Utilized mortality data from 1994-2005 Centers for Disease Control National Vital Statistics Reports for 16 Southeast states.
  • Analyzed data separately for periods before (1994-1998) and after (1999-2005) the ICD code revision.
  • Employed comparability ratios for pooled analysis (1994-2005) and confidence interval analysis to compare rates at the year of code change.

Main Results:

  • Overall trends of decreasing heart disease and cerebrovascular disease mortality, and increasing diabetes mortality from 1994-2005 were not altered by the ICD code revision.
  • However, the transition to ICD-10 in 1999 led to an underestimation of heart disease and cerebrovascular disease mortality and an overestimation of diabetes mortality rates in the Southeast US.

Conclusions:

  • While overall long-term trends remained consistent, the ICD code revision introduced biases in specific disease mortality rates.
  • Health and disease burden profiles relying on mortality data must account for the influence of ICD code revisions.
  • Primary care providers should critically evaluate the comparability of mortality data across ICD code revisions before drawing conclusions.

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