Capturing diagnosis-timing in ICD-coded hospital data: recommendations from the WHO ICD-11 topic advisory group on quality and safety.

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Serval ID
serval:BIB_6888DFD147AD
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Capturing diagnosis-timing in ICD-coded hospital data: recommendations from the WHO ICD-11 topic advisory group on quality and safety.
Journal
International Journal For Quality In Health Care : Journal of the International Society For Quality In Health Care / Isqua
Author(s)
Sundararajan V., Romano P.S., Quan H., Burnand B., Drösler S.E., Brien S., Pincus H.A., Ghali W.A.
ISSN
1464-3677 (Electronic)
ISSN-L
1353-4505
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
27
Number
4
Pages
328-333
Language
english
Notes
Publication types: Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
Publication Status: ppublish
Abstract
PURPOSE: To develop a consensus opinion regarding capturing diagnosis-timing in coded hospital data.
METHODS: As part of the World Health Organization International Classification of Diseases-11th Revision initiative, the Quality and Safety Topic Advisory Group is charged with enhancing the capture of quality and patient safety information in morbidity data sets. One such feature is a diagnosis-timing flag. The Group has undertaken a narrative literature review, scanned national experiences focusing on countries currently using timing flags, and held a series of meetings to derive formal recommendations regarding diagnosis-timing reporting.
RESULTS: The completeness of diagnosis-timing reporting continues to improve with experience and use; studies indicate that it enhances risk-adjustment and may have a substantial impact on hospital performance estimates, especially for conditions/procedures that involve acutely ill patients. However, studies suggest that its reliability varies, is better for surgical than medical patients (kappa in hip fracture patients of 0.7-1.0 versus kappa in pneumonia of 0.2-0.6) and is dependent on coder training and setting. It may allow simpler and more precise specification of quality indicators.
CONCLUSIONS: As the evidence indicates that a diagnosis-timing flag improves the ability of routinely collected, coded hospital data to support outcomes research and the development of quality and safety indicators, the Group recommends that a classification of 'arising after admission' (yes/no), with permitted designations of 'unknown or clinically undetermined', will facilitate coding while providing flexibility when there is uncertainty. Clear coding standards and guidelines with ongoing coder education will be necessary to ensure reliability of the diagnosis-timing flag.
Keywords
Advisory Committees, Data Collection/methods, Data Collection/standards, Diagnosis, Hospital Mortality, Hospitals/standards, Hospitals/statistics & numerical data, Humans, International Classification of Diseases/standards, Patient Safety/standards, Patient Safety/statistics & numerical data, Quality Improvement/standards, Quality Improvement/statistics & numerical data, Quality of Health Care/standards, Quality of Health Care/statistics & numerical data, Time Factors
Pubmed
Web of science
Open Access
Yes
Create date
22/09/2015 16:32
Last modification date
25/09/2019 6:09
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