Background

Administrative healthcare databases are frequently used for child physical abuse (CPA)-related research and surveillance. In October 2015, the United States transitioned to the International Classification of Diseases, Clinical Modification-10th Revision (ICD-10-CM) coding regimen. ICD-10-CM expands coding related to CPA, including codes to differentiate suspected from confirmed CPA.

Objective

This study examined the impact of the transition to ICD-10-CM coding on population-level trends in rates of hospitalizations coded for CPA.

Participants and settings

Hospitalizations coded as related to CPA in children <5 years-of-age from 2010 to 2017 were identified across 19 Statewide Inpatient Databases.

Methods

Interrupted time series analyses were used to assess the impact of the coding transition on hospitalizations coded for CPA, overall and by child race/ethnicity.

Results

Of 9715 hospitalizations coded for CPA, 2797 (29%) occurred after the coding transition, including 51% coded for suspected CPA and 49% coded for confirmed CPA. There was a marginally-significant increase in the trend in CPA-related hospitalization after the coding transition among all children (0.09 per 100,000 children-per-quarter, p = 0.06), a significant increase in the trend among white children (0.15 per 100,000 children-per-quarter, p = 0.01), and no change among Black or Hispanic children. After the coding transition, hospitalizations coded for suspected CPA increased significantly overall (0.10 per 100,000 children-per-quarter, p < 0.001), and in particular among white children (0.12 per 100,000 children-per-quarter, p = 0.01) but not among Black or Hispanic children.

Conclusions

The transition to ICD-10-CM differentially impacted trends in hospitalizations coded for CPA by child race/ethnicity. Further research is necessary to discern the reasons for these discrepancies.

中文翻译：

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识别幼儿身体虐待相关的住院治疗：过渡到 ICD-10-CM 编码的影响

背景

行政医疗保健数据库经常用于与儿童身体虐待 (CPA) 相关的研究和监测。2015 年 10 月，美国过渡到国际疾病分类临床修订第 10 版 (ICD-10-CM) 编码方案。ICD-10-CM 扩展了与 CPA 相关的编码，包括区分可疑CPA和已确认CPA 的代码。

客观的

本研究探讨了向 ICD-10-CM 编码过渡对 CPA 编码住院率的人群水平趋势的影响。

参与者和设置

在 19 个全州住院患者数据库中确定了 2010 年至 2017 年 5 岁以下儿童中与 CPA 相关的住院治疗。

方法

中断时间序列分析用于评估编码转换对 CPA 编码住院的影响，总体和儿童种族/民族。

结果

在 CPA 编码的 9715 例住院治疗中，2797 例（29%）发生在编码转换之后，其中 51% 编码为疑似CPA，49% 编码为确诊CPA。在所有儿童的编码转换后，CPA 相关住院的趋势略有显着增加（每季度每 100,000 名儿童 0.09，p  = 0.06），白人儿童的趋势显着增加（每 100,000 名儿童中的 0.15每季度儿童，p  = 0.01），黑人或西班牙裔儿童没有变化。编码转换后，编码为疑似CPA 的住院人数总体显着增加（每季度每 100,000 名儿童 0.10 人，p < 0.001），尤其是在白人儿童中（每季度每 100,000 名儿童 0.12 名，p  = 0.01），但在黑人或西班牙裔儿童中则不然。

结论

向 ICD-10-CM 的过渡对儿童种族/民族编码为 CPA 的住院治疗趋势产生了不同的影响。需要进一步的研究来找出这些差异的原因。