Transcript ICD-11 ICD and morbidity statistics in Australia ppt

ICD and morbidity
statistics in Australia
1 July 2011
Overview
• History of ICD for morbidity statistics in
Australia
• Major uses of ICD for morbidity statistics
• Importance of ICD revisions for morbidity
statistics
History of ICD and morbidity
statistics in Australia
Hospitals coded diagnosis data in Australia
• Australian Institute of Health established 1987
– by the 1980s most S&T using a version of ICD-9-CM
– variation between states for coding hospitals data
– rising tide of government interest in consolidated set of national
hospital data for policy and funding purposes
• 1993-94 national reporting of morbidity data using ICD-9CM (various US versions) AIHW published Australian
hospital statistics 1993-95: an overview
History of ICD and morbidity
statistics in Australia
• National Coding Centre established in 1994
– Major driver Casemix interests but also policy, hospital management
and clinical interests
– aim to standardise and refine codes and coding practice for these
purposes
• 1995-96 all national reporting using the first Australian
edition of ICD-9-CM
• 1999-00 all S&T reported nationally using ICD-10-AM
• Currently all S&T reporting using ICD-10-AM 7th edition
Importance of ICD for morbidity
statistics
The Productivity Commission undertook a study comparing performance
of public and private hospitals using coded hospitals data in a number of
analyses – Public and Private Hospitals, Productivity Commission
Research Report 2009.
This report highlighted the importance of the coded
hospitals data in the current health environment in
Australia.
Importance of ICD for morbidity
statistics - Policy settings and uses
• National Healthcare Agreement (2008)
– Performance indicators and benchmarks
• National Partnership Agreements
• Heads of Agreement - National Health Reform (2011)
– work in partnership to improve health outcomes and
system sustainability
– Performance and accountability framework, with
information requirements and performance indicators
Importance of ICD for morbidity
statistics
– NHA Performance Indicators (PIs) using coded
hospitals data
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Selected potentially preventable hospitalisations
Falls resulting in harm in hospitals
Unplanned/unexpected readmissions
Intentional self-harm in hospitals
Hospitalisations for injury and poisoning
Cost per casemix adjusted separation
Falls resulting in patient harm in
hospitals (NHA), 2007-08
3
12
2.5
2
8
1.5
1
4
0.5
0
0
0–24
25–44
45–64
Age group
65–84
85 or over
1Lowest
Per 1,000 hospitalisations
2
3
4
Socio-economic group
5Highest
Potentially preventable hospitalisations:
a measure of non-hospital care
Separations per 1,000 population
80
Vaccine-preventable
Acute
Diabetes complications
Chronic (without diabetes)
Total
70
60
50
40
30
20
10
0
Very remote
Remote
Outer regional Inner regional
Major cities
Importance of ICD for morbidity
statistics - current major uses nationally
• AIHW reports
– Australia’s Health – international, national, state and
territory
– Australian Hospital Statistics
- state and territory, hospital
peer groups, public and private
Importance of ICD for morbidity
statistics - other national reports
• Council of Australian
Governments Reform Council
annual performance reports
• Report on Government
Services, produced by a multijurisdictional officials committee
Importance of ICD for morbidity
statistics
• MyHospitals website – information
about individual hospitals
Importance of ICD for morbidity
statistics
o ACSQHC Core hospital-based outcome indicators
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being designed for use at hospital level to support quality
and safety activities
 Hospital Standardised Mortality Ratio
 Death in low-mortality Diagnosis Related Groups
 In-hospital mortality for heart failure, stroke, fractured neck of femur,
pneumonia
 Unplanned re-admissions of patients discharged following management
of:
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acute myocardial infarction
heart failure
knee and hip replacements
depression
schizophrenia
paediatric tonsillectomy and adenoidectomy
ICD revisions and morbidity
statistics
• The 10th revision - a major revision which
allowed collection of more contemporary and
relevant statistical information
– ~8,000 categories compared with ~4,000 categories
– introduction of activity codes V01-Y34 to indicate the activity of
the injured person at the time the event occurred
– Code changes e.g.
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chronic renal failure
paraplegia
austosomal deletion syndromes
congenital pneumonia
ICD revisions and morbidity
statistics
• Congenital pneumonia
– ICD-9 770.0 congenital pneumonia
– ICD-10 P23-Congenital pneumonia
ICD revisions and morbidity
statistics
Examples
• Chronic renal failure
– ICD-9 585.1 chronic renal impairment and 585.9
chronic renal failure
– ICD-10 N18 Chronic kidney disease
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N18.1
Chronic kidney disease, stage 1
N18.2
Chronic kidney disease, stage 2
N18.3
Chronic kidney disease, stage 3
N18.4
Chronic kidney disease, stage 4
N18.5
Chronic kidney disease, stage 5
N18.9
Chronic kidney disease, unspecified
ICD-10 edition changes
Examples of new codes
• U04 Severe acute respiratory syndrome [SARS]
• J09 Influenza due to identified avian influenza virus
Examples of planned changes to be implemented
Jan 2013
• I48 Atrial fibrillation and flutter
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I48.0
I48.1
I48.2
I48.3
I48.4
Paroxysmal atrial fibrillation
Persistent atrial fibrillation
Chronic atrial fibrillation
Typical atrial flutter -Type I atrial flutter
Atypical atrial flutter - Type II atrial flutter
– I48.9 Atrial fibrillation and atrial flutter, unspecified
ICD-10 edition changes - cont
• W17 Fall from one level to another
– Includes: fall from or into:
• cherry picker
• hole
• lifting device
• mobile elevated work platform [MEWP]
• pit
• sky lift
In summary
Revisions to the classifications are important for
morbidity statistics to ensure:
– advances in medical science and diagnostic
terminology are reflected
– public health utility of the classification is maintained
or improved