Abstract
Abstract
Background
We aimed to estimate the impact of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding transition on traumatic injury-related hospitalization trends among young adults across a geographically and demographically diverse group of U.S. states.
Methods
Interrupted time series analyses were conducted using statewide inpatient databases from 12 states and including traumatic injury-related hospitalizations in adults aged 19–44 years in 2011–2017. Segmented regression models were used to estimate the impact of the October 2015 coding transition on external cause of injury (ECOI) completeness (percentage of hospitalizations with a documented ECOI code) and on population-level rates of injury-related hospitalizations by nature, intent, mechanism, and severity of injury.
Results
The transition to ICD-10-CM was associated with a drop in ECOI completion in the transition month (− 3.7%; P < .0001), but there was no significant change in the positive trend in ECOI completion from the pre- to post-transition periods. There were significant increases post-transition in the measured rates of hospitalization for traumatic brain injury (TBI), unintentional injury, mild injury (injury severity score (ISS) < 9), and injuries caused by drowning, firearms, machinery, other pedestrian, suffocation, and unspecified mechanism. Conversely, there were significant decreases in October 2015 in the rates of hospitalization for assault, injuries of undetermined intent, injuries of moderate severity (ISS 9–15), and injuries caused by fire/burn, other pedal cyclist, other transportation, natural/environmental, and other specified mechanism. A significant increase in the percentage of hospitalizations classified as resulting from severe injury (ISS > 15) was observed when the general equivalence mapping maximum severity method for converting ICD-10-CM codes to ICD-9-CM codes was used. State-specific results for the outcomes of ECOI completion and TBI-related hospitalization rates are provided in an online supplement.
Conclusions
The U.S. transition from ICD-9-CM to ICD-10-CM coding led to a significant decrease in ECOI completion and several significant changes in measured rates of injury-related hospitalizations by injury intent, mechanism, nature, and severity. The results of this study can inform the design and analysis of future traumatic injury-related health services research studies that use both ICD-9-CM and ICD-10-CM coded data.
Level of evidence
II (Interrupted Time Series)
Funder
National Center on Minority Health and Health Disparities
Publisher
Springer Science and Business Media LLC
Reference31 articles.
1. Abajas-Bustillo R, Amo-Setién FJ, Leal-Costa C, Ortego-Mate MDC, Seguí-Gómez M, Durá-Ros MJ, et al. Comparison of injury severity scores (ISS) obtained by manual coding versus “Two-step conversion” from ICD-9-CM. PLoS One. 2019;14(5):e0216206.
2. Annest JL, Hedegaard H, Chen L-H, Warner M, Smalls E. Proposed framework for presenting injury data using ICD-10-CM external cause of injury codes. Atlanta: National Center for Injury Prevention and Control, National Center for Health Statistics, Centers for Disease Control and Prevention; 2014.
3. Barell V, Aharonson-Daniel L, Fingerhut LA, Mackenzie EJ, Ziv A, Boyko V, et al. An introduction to the Barell body region by nature of injury diagnosis matrix. Inj Prev. 2002;8(2):91–6.
4. Centers for Disease Control and Prevention. Strategies to Improve External Cause-of-Injury Coding in State-Based Hospital Discharge and Emergency Department Data Systems: Recommendations of the CDC Workgroup for Improvement of External Cause-of-Injury Coding. MMWR Recomm Rep. 2008;57(RR-1):1–15.
5. Centers for Disease Control and Prevention. Table 1. Recommended framework of E-code groupings for presenting injury mortality and morbidity data (August 10, 2011), 2018. Available from: https://www.cdc.gov/injury/wisqars/ecode_matrix.html. Accessed 19 June 2020.
Cited by
15 articles.
订阅此论文施引文献
订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献