The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), implemented in 2015, has more codes than ICD-9-CM for events involving cannabis. We examined cannabis indicator trends across the transition from ICD-9-CM to ICD-10-CM in Colorado, where state law regulates adult cannabis use. Using 2011 to 2018 data from hospital and emergency department (ED) discharges, we calculated monthly rates per 1000 discharges for two indicators: (1) cannabis use disorders and (2) poisoning and adverse effects of psychodysleptics. Immediate, point-of-transition (level) and gradual, post-transition (slope) changes across the ICD-9-CM to ICD-10-CM transition were tested using interrupted time series models adjusted for legalisation, seasonality and autocorrelation. We observed a level increase and slope increase in the rate of ED discharges with cannabis use disorders. Hospital discharges with cannabis use disorders had a negative slope change after the transition and no level change. ED discharges with poisoning and adverse effects of psychodysleptics showed an increase in slope after the transition. No effects of the transition were observed on hospital discharges with poisoning and adverse effects of psychodysleptics. Shifts in the level and slope of cannabis indicator rates after implementation of the new coding scheme suggest the use of caution when interpreting trends spanning the ICD-9-CM to ICD-10-CM transition.

中文翻译：

---

在 ICD-10-CM 过渡期间科罗拉多州大麻编码的中断时间序列分析

2015 年实施的国际疾病分类第 10 版临床修订版 (ICD-10-CM) 比 ICD-9-CM 具有更多的代码，用于涉及大麻的事件。我们研究了科罗拉多州从 ICD-9-CM 过渡到 ICD-10-CM 的大麻指标趋势，那里的州法律规范成人大麻的使用。使用 2011 年至 2018 年医院和急诊科 (ED) 出院的数据，我们计算了每 1000 次出院的月率有两个指标：(1) 大麻使用障碍和 (2) 精神分裂症的中毒和不良反应。使用针对合法化、季节性和自相关性调整的中断时间序列模型测试了从 ICD-9-CM 到 ICD-10-CM 过渡的即时、过渡点（水平）和逐渐的、过渡后（斜率）变化。我们观察到大麻使用障碍导致 ED 放电率的水平增加和斜率增加。因大麻使用障碍出院的患者在过渡后斜率呈负变化，且没有水平变化。伴随精神分裂症中毒和不良反应的 ED 放电显示在过渡后斜率增加。没有观察到转变对中毒出院和精神分裂症不良反应的影响。实施新编码方案后大麻指标率水平和斜率的变化表明在解释从 ICD-9-CM 到 ICD-10-CM 过渡的趋势时要谨慎。伴随精神分裂症中毒和不良反应的 ED 放电显示在过渡后斜率增加。没有观察到转变对中毒出院和精神分裂症不良反应的影响。实施新编码方案后大麻指标率水平和斜率的变化表明在解释从 ICD-9-CM 到 ICD-10-CM 过渡的趋势时要谨慎。伴随精神分裂症中毒和不良反应的 ED 放电显示在过渡后斜率增加。没有观察到转变对中毒出院和精神分裂症不良反应的影响。实施新编码方案后大麻指标率水平和斜率的变化表明在解释从 ICD-9-CM 到 ICD-10-CM 过渡的趋势时要谨慎。