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Application of the Diagnosis Grouping System to Pediatric Emergency Department Encounters
Sriram Ramgopal1, Colleen Fant1, Jennifer R Marin2
1Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Insights
The Diagnosis Grouping System (DGS) effectively classifies pediatric emergency department diagnoses across diverse US health systems. This study confirms DGS utility for research, showing comparable diagnostic patterns in children's emergency care.
Area of Science:
- Health Services Research
- Pediatric Emergency Medicine
- Epidemiology
Background:
- Diagnosis grouping systems are crucial for health services, epidemiological studies, and health outcomes research.
- The Diagnosis Grouping System (DGS) was specifically developed to categorize International Classification of Diseases, 10th Revision (ICD-10) diagnosis codes for pediatric emergency department (ED) encounters.
Purpose of the Study:
- To apply and compare the DGS to large-scale US pediatric ED encounters.
- To evaluate the DGS's effectiveness across three distinct health system databases.
Main Methods:
- A retrospective cross-sectional study analyzed pediatric ED encounters (younger than 18 years) from 2016 to 2021.
- Data sources included the National Hospital Ambulatory Medical Care Survey (NHAMCS), COMPdata (Illinois), and Pediatric Health Information Systems (PHIS).
- Principal diagnoses were categorized using the DGS, and their distributions were compared across datasets.
Main Results:
- The study analyzed millions of pediatric ED encounters across NHAMCS, COMPdata, and PHIS datasets.
- Trauma was the most frequent diagnosis group (17.0%–22.2%) across all datasets.
- Specific conditions like sickle cell anemia, diabetes, appendicitis, seizures, and asthma were more prevalent in the PHIS sample.
Conclusions:
- Comparable diagnostic distributions were observed across the analyzed datasets, with variations attributed to data source characteristics.
- The findings establish a baseline for pediatric diagnoses, supporting future research on pediatric ED utilization.
- The DGS demonstrates utility in classifying pediatric emergency diagnoses for research purposes.
Objective:
Diagnosis grouping systems are essential for health services and epidemiological and health outcomes research. The Diagnosis Grouping System (DGS) was developed to classify International Classification of Diseases, 10th Revision diagnosis codes for pediatric emergency department (ED) encounters. We applied and compared the DGS to large samples of US ED encounters for children using 3 large health system databases.
Methods:
We conducted a retrospective cross-sectional study of children (younger than age 18 years) between 2016 and 2021 using 3 ED datasets: the National Hospital Ambulatory Medical Care Survey (NHAMCS; a complex survey of US ED encounters), COMPdata (a dataset of encounters for Illinois), and the Pediatric Health Information Systems (PHIS; an administrative database of US children's hospitals). We categorized principal diagnoses using the DGS and compared their distribution.
Results:
We included 181 607 978 survey-weighted encounters from NHAMCS, 5 352 016 encounters from COMPdata, and 20 859 019 encounters from PHIS. A higher proportion of encounters in the PHIS sample were admitted or transferred (12.7%) compared with those in the NHAMCS (6.1%) or COMPdata (4.2%) samples. Trauma was the most common major group identified among all datasets (22.0% in NHAMCS, 22.2% in COMPdata, and 17.0% in PHIS). Some conditions, such as sickle cell anemia, diabetes mellitus, appendicitis, seizures, and asthma, presented more frequently among children presenting to the PHIS hospitals.
Conclusions:
We identified comparable diagnostic distributions across different datasets, with differences that are likely attributable to specific characteristics of the data source. Our findings provide a baseline for pediatric diagnoses to facilitate future research on pediatric ED utilization.
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