儿科复杂慢性疾病系统版本3
James A Feinstein1,2,3, Matt Hall4, Amber Davidson4
1Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora.
JAMA network open
|July 15, 2024
概括
更新的儿科复杂慢性疾病 (CCC) V3系统准确地反映了不断变化的ICD-10-CM代码,在解释医院结果方面显示了与V2相似的性能. 建议对V3进行持续更新,以准确表示临床状况.
科学领域:
- 儿科健康信息学 儿科健康信息学
- 临床分类系统临床分类系统
- 医疗保健服务研究 医疗服务研究
背景情况:
- 疾病国际统计分类,第十次修订,临床修改 (ICD-10-CM) 引入了许多新的代码.
- 儿科复杂慢性疾病 (CCC) 系统需要从V2更新到V3,以与ICD-10-CM的变化保持一致.
研究的目的:
- 更新CCC系统到V3,结合新的,缺失的或退休的ICD-10-CM代码.
- 在CCC系统中重新评估技术代码的使用.
- 为了比较CCC V3与CCC V2的性能.
主要方法:
- 一项重复的横截面研究分析了来自儿科健康信息系统 (PHIS) 和Medicaid Merative MarketScan研究数据库的美国儿科住院数据 (2009-2019).
- 复杂慢性疾病 (CCC) 通过CCC V2 和 V3 系统进行鉴定.
- 比较的关键结果包括CCC住院的百分比,每名患者的CCC体系类别数量,以及系统对住院时间和住院死亡率的解释能力.
主要成果:
- CCC V2发现了40.1%的PHIS住院患者患有CCC,而V3.3发现的这一比例为38.3%. 与V2.2.相比,V3发现了更多的移植病例 (2.0%对1.4%),但技术代码较少 (11.2%对12.7%).
- V2和V3在分类CCC和解释住院时间 (10.0%) 和住院死亡率 (12.0%) 的变化方面表现出类似的能力.
- 在MarketScan数据库中观察到类似的模式,V2确定了25.3%的CCC住院病例,而V3.3发现了23.9%.
结论:
- 建议使用CCC V3系统来识别儿科复杂慢性疾病.
- 对CCC V3系统的定期,透明的更新对于保持与不断变化的ICD-10-CM代码的准确性至关重要.
- 维3系统有效地捕捉了儿科住院的临床条件的范围.
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