Feasibility of extracting cancer stage and metastasis codes from health insurance claims of outpatients and expressibility in ICD-11: a cross-sectional study using national health insurance data from South Korea

Author:

Park Young-TaekORCID,Han DongwoonORCID,Kim Kyoung-HoonORCID,Kim Hoguen,Yoon Hojung Joseph,Lane Chris,Kim Byeo-Ri,Jeong Joo-Yeon

Abstract

ObjectivesThis study aimed to evaluate the incidence of health insurance claims recording the cancer stage and TNM codes representing tumor extension size (T), lymph node metastasis (N), and distant metastasis (M) for patients diagnosed with cancer and to determine whether this extracted data could be applied to the new ICD-11 codes.DesignA cross-sectional study design was used, with the units of analysis as individual outpatients. Two dependent variables were extraction feasibility of cancer stage and TNM metastasis information from each claim. Expressibility of the two variables in ICD-11 was descriptively analysed.Setting and participantsThe study was conducted in South Korea and study participants were outpatients: lung cancer (LC) (46616), stomach cancer (SC) (50103) and colorectal cancer (CC) (54707). The data set consisted of the first health insurance claim of each patient visiting a hospital from 1 July to 31 December 2021.ResultsThe absolute extraction success rates for cancer stage based on claims with cancer stage was 33.3%. The rates for stage for LC, SC and CC were 30.1%, 35.5% and 34.0%, respectively. The rate for TNM was 11.0%. The relative extraction success rates for stage compared with that for CC (the reference group) were lower for patients with LC (adjusted OR (aOR), 0.803; 95% CI 0.782 to 0.825; p<0.0001) but higher for SC (aOR 1.073; 95% CI 1.046 to 1.101; p<0.0001). The rates of TNM compared that for CC were 40.7% lower for LC (aOR, 0.593; 95% CI 0.569 to 0.617; p<0.0001) and 43.0% lower for SC (aOR 0.570; 95% CI 0.548 to 0.593; p<0.0001). There were limits to expressibility in ICD-11 regarding the detailed cancer stage and TNM metastasis codes.ConclusionExtracting cancer stage and TNM codes from health insurance claims were feasible, but expressibility in ICD-11 codes was limited. WHO may need to create specific cancer stage and TNM extension codes for ICD-11 due to the absence of current rules in ICD-11.

Funder

The Health Insurance Review and Assessment Service

Publisher

BMJ

Reference35 articles.

1. World Health Organization . ICD-11 2022 release. 2022. Available: https://www.who.int/news/item/11-02-2022-icd-11-2022-release

2. Australian Institute of Health and Welfare . ICD-11 review Stakeholder consultation report 2019 cat. No HWI 31. Canberra: AIHW. n.d. Available: https://www.aihw.gov.au/getmedia/9ca5f240-ab0f-40ba-9ed7-15216de2cb88/aihw-HWI-31.pdf.aspx?inline=true

3. Diagnostic classification of irritability and Oppositionality in youth: a global field study comparing ICD-11 with ICD-10 and DSM-5;Evans;J Child Psychol Psychiatry,2021

4. Michael Frost . World Health Organization Collaborating Centre for the Family of International Classifications Australia. ICD-11 Stakeholder Update - January 2022. 2022.

5. Assessment of the ICD-11 dimensional trait model: an introduction to the special section;Bagby;Psychol Assess,2020

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3