健康的社会决定因素 ICD-10代码由大型综合医疗保健系统使用
Cynthia Hau1, Janet M Grubber1, Ryan E Ferguson1,2
1Cooperative Studies Program Coordinating Center, VA Boston Healthcare System, Boston, MA 02111, USA.
Healthcare (Basel, Switzerland)
|November 13, 2025
概括
健康的社会决定因素 (SDOH) 代码在退伍军人事务 (VA) 卫生系统中越来越多地使用. 然而,系统的年度SDOH评估尚未成为标准做法,需要进一步开发通用查工具.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生信息学 公共卫生信息学
- 临床数据分析 临床数据分析
背景情况:
- 确定健康的社会决定因素 (SDOH) 对于有效的临床护理和数据驱动的医疗保健至关重要.
- 国际疾病分类,第10次修订 (ICD-10) 对不良SDOH的代码存在,但在许多卫生系统中未得到充分利用.
- 本研究检查了SDOH代码在一个大型综合医疗保健系统,美国退伍军人事务部 (VA) 中的利用情况.
研究的目的:
- 评估VA医疗保健系统中ICD-10 SDOH代码的使用模式.
- 在六年时间内分析SDOH代码文档的趋势.
- 确定在综合医疗保健环境中改善SDOH数据收集的挑战和机会.
主要方法:
- 利用了来自13,523名参与者实用的Diuretic Comparison Project试验 (2016-2022) 的现实世界临床数据.
- 从VA内部的电子健康记录中提取并分析了ICD-10 SDOH记录.
- 评估了跨研究年和门诊类型的SDOH代码使用情况.
主要成果:
- 总共有29,305个SDOH记录被确定,其中99.2%来自门诊接触.
- 社会,精神和住房护理服务产生了最多的SDOH记录.
- 参与者SDOH记录的流行率从第一年的6.9%增加到第六年的10.3%,表明文档有所改善.
结论:
- 在VA中,SDOH代码的使用呈现出积极的趋势,这表明向系统性文档化迈进.
- 在所有综合卫生环境中,SDOH评估可能不会每年或系统地发生.
- 需要进一步开发通用查工具和强制性常规SDOH评估,以充分利用这些数据为患者护理.
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