Diagnostic coding of chronic physical conditions in Irish general practice

Abstract

Background Chronic conditions are responsible for significant mortality and morbidity among the population in Ireland. It is estimated that almost one million people are affected by one of the four main categories of chronic disease (cardiovascular disease, chronic obstructive pulmonary disease, asthma, and diabetes). Primary healthcare is an essential cornerstone for individuals, families, and the community and, as such, should play a central role in all aspects of chronic disease management. Aim The aim of the project was to examine the extent of chronic disease coding of four chronic physical conditions in the general practice setting. Methods The design was a descriptive cross-sectional study with anonymous retrospective data extracted from practices. Results Overall, 8.8% of the adult population in the six participating practices were coded with at least one chronic condition. Only 0.7% of adult patients were coded with asthma, 0.3% with COPD, 3% with diabetes, and 3.3% with CVD. Male patients who visited their GP in the last year were more likely to be coded with any of the four chronic diseases in comparison with female patients. A significant relationship between gender and being coded with diabetes and CVD was found. Conclusions For a likely multitude of reasons, diagnostic coding in Irish general practice clinics in this study is low and insufficient for an accurate estimation of chronic disease prevalence. Monitoring of information provided through diagnostic coding is important for patients’ care and safety, and therefore appropriate training and reimbursement for these services is essential.

National Chronic Disease Management Programmes in Irish General Practice-Preparedness and Challenges

“…A national-level survey conducted back in 2011 also stressed increased staff workload and lack of appropriate funding as the critical barrier to CDM implementation in Irish general practices [ 11 ]. Similar issues has been highlighted in the international literature [ 18 , 19 ] and our group has previously reported on the importance of expanding practice nursing for Irish general practice [ 24 ].…”

“…In the UK, Anwar et al noted that general practices in deprived areas had significantly higher burdens of chronic diseases, with access to care in busy practices becoming increasingly difficult [ 17 ]. Pericin et al identified the inadequacy of coding of chronic diseases in Irish general practices as a potential barrier to implementation of structured care [ 18 ].…”