评估链接的ICD-10医疗保险索赔数据作为一种在研究环境中确定痴呆病例的方法
Joya Bhattacharyya1, Lisa L Barnes2,3, Yi Chen2
1Department of Epidemiology, George Washington University, Washington, District of Columbia, USA.
概括
国际疾病分类,第10版 (ICD-10) 代码在医疗保险索赔中准确地识别痴呆病例,但在老年人,少数种族群体和患有抑郁症状或中风史的人群中表现不那么有效.
科学领域:
- 老年学是一门学科.
- 医疗信息学 医疗信息学
- 流行病学 流行病学
背景情况:
- 美国医疗保险索赔是研究中识别痴呆病例的宝贵资源.
- 评估诊断码的性能对于准确的流行病学研究至关重要.
研究的目的:
- 为了评估国际疾病分类第十次修订 (ICD-10) 认定痴呆症的准确性,编码定义.
- 将ICD-10代码的性能与已建立的基于研究的痴呆症标准进行比较.
主要方法:
- 利用了来自拉什阿尔茨海默病中心 (RADC) 的五个队伍 (2015-2019) 的数据.
- 根据六个ICD-10代码定义,对1869名参与者的基于研究的痴呆症确定进行了痴呆症状态的比较.
- 分析了各种人口和临床子组的表现.
主要成果:
- ICD-10代码定义在识别痴呆症方面表现出很高的准确性 (87%-90%).
- 在六个ICD-10代码定义中的五个优先考虑了特异性而不是敏感性.
- 在老年参与者,少数种族群体和患有抑郁症状或中风史的人群中观察到绩效差异.
结论:
- 对于痴呆症确定的ICD-10代码性能通常是可靠的,但显示了变化.
- 意识到各个子组的差异性表现对于提高研究稳定性至关重要.
- 结果表明ICD-10的性能与之前的ICD-9代码相匹配.
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