在 ICD-10-CM 编码出院数据中定义药物过量急诊就诊和住院的指标,Injury Prevention

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在 ICD-10-CM 编码出院数据中定义药物过量急诊就诊和住院的指标
Injury Prevention ( IF 3.7 ) Pub Date : 2021-03-01 , DOI: 10.1136/injuryprev-2019-043521
Alana Vivolo-Kantor ₁ , Emilia Pasalic ₂ , Stephen Liu ₂ , Pedro D Martinez ₂ , Robert Matthew Gladden ₂ ,

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介绍药物过量流行在过去十年中恶化；然而，已经努力使用各种数据源，包括来自账单和出院文件的急诊科和入院数据，更好地了解和跟踪非致命性药物过量。方法和结果疾病控制与预防中心 (CDC) 使用标准化的出院诊断代码为公共卫生从业人员和流行病学家制定了监测病例定义指南，并利用从 CDC 资助的受助者和州和地区流行病学家委员会 (CSTE) 国际分类中吸取的经验教训疾病，第 10 次修订，临床修改 (ICD-10-CM) 药物中毒指标工作组和一般损伤 ICD-10-CM 工作组。CDC 的指南由卫生部门和 CSTE 的工作组提供，其中包括评估急诊科药物过量和住院出院数据的几个关键方面。这些包括： (1) 搜索所有诊断字段以识别药物过量病例；(2) 使用初次接触的就诊估计药物过量发生率，但不包括随后的接触和后遗症；（三）从药物过量发生率指标中剔除剂量不足和不良反应；(4) 使用代码 T36-T50 进行药物过量监测。CDC 的指南还建议单独分析 ICD-10-CM 编码的意图。结论 CDC 的指南为卫生部门提供了一个关键工具，以更好地监测其社区中的药物过量使用情况。

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Defining indicators for drug overdose emergency department visits and hospitalisations in ICD-10-CM coded discharge data

Introduction The drug overdose epidemic has worsened over the past decade; however, efforts have been made to better understand and track nonfatal overdoses using various data sources including emergency department and hospital admission data from billing and discharge files. Methods and findings The Centers for Disease Control and Prevention (CDC) has developed surveillance case definition guidance using standardised discharge diagnosis codes for public health practitioners and epidemiologists using lessons learnt from CDC’s funded recipients and the Council for State and Territorial Epidemiologists (CSTE) International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) Drug Poisoning Indicators Workgroup and General Injury ICD-10-CM Workgroup. CDC’s guidance was informed by health departments and CSTE’s workgroups and included several key aspects for assessing drug overdose in emergency department and hospitalisation discharge data. These include: (1) searching all diagnosis fields to identify drug overdose cases; (2) estimating drug overdose incidence using visits for initial encounter but excluding subsequent encounters and sequelae; (3) excluding underdosing and adverse effects from drug overdose incidence indicators; and (4) using codes T36–T50 for overdose surveillance. CDC’s guidance also suggests analysing intent separately for ICD-10-CM coding. Conclusions CDC’s guidance provides health departments a key tool to better monitor drug overdoses in their community. The implementation and validation of this standardised guidance across all CDC-funded health departments will be key to ensuring consistent and accurate reporting across all entities.

更新日期：2021-03-05

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