Exploring the differences in ICD and hospital morbidity data collection features across countries: an international survey

Abstract

Background The International Classification of Diseases (ICD) is the reference standard for reporting diseases and health conditions globally. Variations in ICD use and data collection across countries can hinder meaningful comparisons of morbidity data. Thus, we aimed to characterize ICD and hospital morbidity data collection features worldwide. Methods An online questionnaire was created to poll the World Health Organization (WHO) member countries that were using ICD. The survey included questions focused on ICD meta-features and hospital data collection systems, and was distributed via SurveyMonkey using purposive and snowball sampling. Accordingly, senior representatives from organizations specialized in the topic, such as WHO Collaborating Centers, and other experts in ICD coding were invited to fill out the survey and forward the questionnaire to their peers. Answers were collated by country, analyzed, and presented in a narrative form with descriptive analysis. Results Responses from 47 participants were collected, representing 26 different countries using ICD. Results indicated worldwide disparities in the ICD meta-features regarding the maximum allowable coding fields for diagnosis, the definition of main condition, and the mandatory type of data fields in the hospital morbidity database. Accordingly, the most frequently reported answers were “reason for admission” as main condition definition (n = 14), having 31 or more diagnostic fields available (n = 12), and “Diagnoses” (n = 26) and “Patient demographics” (n = 25) for mandatory data fields. Discrepancies in data collection systems occurred between but also within countries, thereby revealing a lack of standardization both at the international and national level. Additionally, some countries reported specific data collection features, including the use or misuse of ICD coding, the national standards for coding or lack thereof, and the electronic abstracting systems utilized in hospitals. Conclusions Harmonizing ICD coding standards/guidelines should be a common goal to enhance international comparisons of health data. The current international status of ICD data collection highlights the need for the promotion of ICD and the adoption of the newest version, ICD-11. Furthermore, it will encourage further research on how to improve and standardize ICD coding.

A Model for Clinical Coder Satisfaction in Saudi Arabia Based on a Holistic Approach: Clinical, Professional and Organizational Dimensions

“…The results of our study unveil that implementing appropriate coding policies enhances the satisfaction levels of coders and improves coding practice. This finding complies with the study of Otero Varela et al which revealed that lacking coding standards have negatively impacted the quality of clinical coding [23].…”

One Digital Health for more FAIRness

“…EHRs' implementation strategies heavily rely on interoperable systems and platforms, which also account for IoT-related tools and services (I1 + , I2 + ) 22 38 47 48 49 50 51 52…”

ADHD and Neurodegenerative Disease Risk: A Critical Examination of the Evidence

“…There is also considerable worldwide variability in the use of the ICD versions, with some countries implementing “clinical modifications” that modify ICD codes according to country-specific needs, e.g., ICD-9-CM and ICD-10-CM in the US, or ICD-10-CA in Canada (Otero Varela et al, 2021 ). These modifications can either include more detailed coding to characterize a patient’s state (generating more individual codes than the original version) or be used to simplify the index terms of the ICD.…”