Experience of Diagnostic Coding In Irish General Practice: The Practice Perspective

Kennedy, Conor; O'Brien, Casey L; Collins, Claire

doi:10.5171/2014.583528

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…When comparing with other countries including the UK, Netherlands, and Australia [30], where data retrieved from general practice represents a rich source of information, in Ireland due to the low level of diagnostic coding, the quality of data collected remains poor [34,42]. Previous research demonstrated that additional extensive training in computer use and coding principles of practice staff could contribute to a better quality of coding [12,42].…”

Section: Discussionmentioning

confidence: 99%

“…Data from this programme are currently returned to the Health Services Executive (HSE) via an electronic portal, however software tools for GPs to appraise their own practice's clinical management, including those that are related to their CDM activity, are not currently available. Although there is an overall agreement on the importance of diagnostic coding as part of general practice data management, technical issues, as well as overall reluctancy to code (due to time constraints and concerns regarding the accuracy of the diagnostic codes), prevent the establishment of global diagnostic coding in Ireland [30]. As a result of the implementation of the Irish government's Sláintecare strategy, the future management of chronic disease will rely more heavily on general practice [31].…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic coding of chronic physical conditions in Irish general practice

Pericin¹,

Larkin²,

Collins³

2021

Ir J Med Sci

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnostic coding of chronic physical conditions in Irish general practice

Pericin¹,

Larkin²,

Collins³

2021

Ir J Med Sci

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“…In Britain, it has been found that most diagnoses coded in the general practice research database are valid [9]. However, many studies have pointed out that doctors tend to undercode [10][11][12] -not all of those diagnosed with an illness are coded as having that illness. Irish GPs have stated in the past that they often do not have the time to code patients [11] and previous research [13] has estimated that only 8% of patients in Irish general practice who had a mental disorder had been coded as having such.…”

Section: Introductionmentioning

confidence: 99%

“…However, many studies have pointed out that doctors tend to undercode [10][11][12] -not all of those diagnosed with an illness are coded as having that illness. Irish GPs have stated in the past that they often do not have the time to code patients [11] and previous research [13] has estimated that only 8% of patients in Irish general practice who had a mental disorder had been coded as having such. Therefore, we sought to use an electronic finder tool to encourage coding of SMDs inpatients.…”

Section: Introductionmentioning

confidence: 99%

Cross-sectional analysis of coding, patient characteristics, consultation frequency and pharmacological treatment of adults with severe mental disorders in Irish general practice

Larkin¹,

Pericin²,

Osborne³

et al. 2021

Ir J Med Sci

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Background General practitioners are the gatekeepers of Irish healthcare and they offer continuity of care to patients. Irish general practice is therefore considered appropriate for preventing, diagnosing and managing most mental health problems. Aims This study sought to establish the coding frequency, consultation frequency, patient characteristics and pharmacological treatment of patients with severe mental disorders (SMDs) in Irish general practice. Methods A cross-sectional design was used. A finder tool embedded in the practice software assisted general practitioners (GPs) coding adult patients with SMDs. Eleven practices uploaded anonymous data on 2,203 patients. Variables analysed included disease code, consultations, prescriptions, sex, patient status and age. Results Overall, 2.9% (n = 2,337) of patients had ever been coded with a SMD, 2.4% (n = 1,964) coded with depressive disorder ever and 0.26% (n = 209) and 0.3% (n = 233) with bipolar disorder and schizophrenia, respectively. Overall, 68.0% (n = 1,336) of patients with depressive disorder were female, and 74.0% (n = 171) of patients with schizophrenia were public patients. The median consultation rate in the previous 3 years was highest for schizophrenia patients at 24.5 visits. Conclusions Coding of SMDs in Irish general practice appears incomplete. Patients with SMDs have high consultation rates. Patients with depressive disorder are more likely to be female and public patients. This research suggests that the improvement of coding in Irish general practice is the first practical step required to detecting prevalence rates.

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