Degenerative Shoulder Diseases: Shoulder Injuries, Epidemiology, ICD10, Coding

Area of Science:

• Orthopedics
• Health Services Research
• Medical Informatics

Background:

• Increasing incidence of shoulder diseases and injuries necessitates understanding disease burden and care patterns.
• Limited data exists on degenerative shoulder conditions, injuries, and physician coding practices (International Classification of Diseases, 10th Revision - ICD-10).

Purpose of the Study:

• To provide a descriptive analysis of coded shoulder diseases and injuries using 2022 health insurance billing data.
• To examine physician coding behavior and the utilization of diagnostic and therapeutic services for shoulder conditions.
• To identify potential disparities in care and coding practices.

Main Methods:

• Analysis of billing data from 4.9 million insured individuals in Baden-Württemberg for the year 2022.
• Categorization of shoulder conditions into accident-related injuries and degenerative diseases.
• Evaluation of ICD-10 coding specificity (specific vs. non-specific codes) and physician specialty.
• Assessment of diagnostic imaging and physiotherapy prescription rates.
• Analysis of comorbidities associated with degenerative shoulder diseases.

Main Results:

• Women (7.3%) were slightly more affected by shoulder diseases than men (6.9%), with women being significantly older at diagnosis.
• General practitioners more frequently used non-specific codes for conditions like joint pain or impingement syndrome.
• Only one-third of patients received imaging, and 40% were prescribed physiotherapy.
• Degenerative shoulder disease patients had higher rates of metabolic diseases and hypertension.

Conclusions:

• Shoulder diseases represent a significant health burden in Germany, affecting both genders.
• There appears to be potential for improving diagnostic specificity and the targeted prescription of therapeutic interventions.
• A clearer understanding of service utilization can guide providers in initiating appropriate care and identifying potential unmet needs within the healthcare system.