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International variation in the definition of ‘main condition' in ICD-coded health data

Quan, H. ; Moskal, L. ; Forster, A.J. ; Brien, S. ; Walker, R. ; Romano, P.S. ; Sundararajan, V. ; Burnand, B. ; Henriksson, G. ; Steinum, O. ; Droesler, S. ; Pincus, H.A. ; Ghali, W.A.

In: International Journal for Quality in Health Care, 2014, vol. 26, no. 5, p. 511-515

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    Titre
    • International variation in the definition of ‘main condition' in ICD-coded health data
    Auteur
    • Quan, H.. Department of Community Health Sciences, University of Calgary, Calgary, Canada
    • Moskal, L.. Canadian Institute for Health Information, Ottawa, Canada
    • Forster, A.J.. Ottawa Hospital Research Institute and Institute for Clinical Evaluative Sciences, Ottawa, Canada
    • Brien, S.. Health Council of Canada, Toronto, Canada
    • Walker, R.. Department of Community Health Sciences, University of Calgary, Calgary, Canada
    • Romano, P.S.. Departments of Internal Medicine and Pediatrics, and Center for Healthcare Policy and Research, University of California Davis, Davis, USA
    • Sundararajan, V.. Department of Medicine, St. Vincent's Hospital, University of Melbourne, Melbourne, Australia
    • Burnand, B.. Institut Universitaire de Médecine Sociale et Préventive, Centre, Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
    • Henriksson, G.. Nordic WHO FIC Collaborating Centre, Oslo, Norway
    • Steinum, O.. Nordic WHO FIC Collaborating Centre, Oslo, Norway
    • Droesler, S.. Faculty of Industrial Engineering and Health Care, Niederrhein University of Applied Sciences, Reinarzstrasse 49, Krefeld, Germany
    • Pincus, H.A.. Department of Psychiatry, Columbia University College of Physicians and Surgeons, Division of Clinical Phenomenology, New York, NY, USA
    • Ghali, W.A.. Department of Community Health Sciences, University of Calgary, Calgary, Canada
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • International Journal for Quality in Health Care, 2014, vol. 26, no. 5, p. 511-515. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:291279
    Summary
    Hospital-based medical records are abstracted to create International Classification of Disease (ICD) coded discharge health data in many countries. The ‘main condition' is not defined in a consistent manner internationally. Some countries employ a ‘reason for admission' rule as the basis for the main condition, while other countries employ a ‘resource use' rule. A few countries have recently transitioned from one of these approaches to the other. The definition of ‘main condition' in such ICD data matters when it is used to define a disease cohort to assign diagnosis-related groups and to perform risk adjustment. We propose a method of harmonizing the international definition to enable researchers and international organizations using ICD-coded health data to aggregate or compare hospital care and outcomes across countries in a consistent manner. Inter-observer reliability of alternative harmonization approaches should be evaluated before finalizing the definition and adopting it worldwide