The Development, Evolution, and Modifications of ICD-10: Challenges to the International Comparability of Morbidity Data.
Jette, Nathalie MD, MSc *; Quan, Hude MD, PhD +; Hemmelgarn, Brenda MD, PhD ++; Drosler, Saskia MD [S]; Maass, Christina Dipl-Ges Oec [S]; Moskal, Lori CHIM [P]; Paoin, Wansa MD [//]; Sundararajan, Vijaya MD, MPH **; Gao, Song MIP, BMed, MSc ++; Jakob, Robert MD ++++; Ustun, Bedihran MD ++++; Ghali, William A. MD, MPH ++; for the IMECCHI Investigators *
48(12):1105-1110, December 2010.
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Background: The United States is about to make a major nationwide transition from ICD-9-CM coding of hospital discharges to ICD-10-CM, a country-specific modification of the World Health Organization's ICD-10. As this transition occurs, the WHO is already in the midst of developing ICD-11. Given this context, we undertook this review to discuss: (1) the history of the International Classification of Diseases (a core information "building block" for health systems everywhere) from its introduction to the current era of ICD-11 development; (2) differences across country-specific ICD-10 clinical modifications and the challenges that these differences pose to the international comparability of morbidity data; (3) potential strategic approaches to achieving better international ICD-11 comparability.
Literature Review and Discussion: A literature review and stakeholder consultation was carried out. The various ICD-10 clinical modifications (ICD-10-AM [Australia], ICD-10-CA [Canada], ICD-10-GM [Germany], ICD-10-TM [Thailand], ICD-10-CM [United States]) were compared. These ICD-10 modifications differ in their number of codes, chapters, and subcategories. Specific conditions are present in some but not all of the modifications. ICD-11, with a similar structure to ICD-10, will function in an electronic health records environment and also provide disease descriptive characteristics (eg, causal properties, functional impact, and treatment).
Conclusion: The threat to the comparability of international clinical morbidity is growing with the development of many country-specific ICD-10 versions. One solution to this threat is to develop a meta-database including all country-specific modifications to ensure more efficient use of people and resources, decrease omissions and errors but most importantly provide a platform for future ICD updates.
(C) 2010 Lippincott Williams & Wilkins, Inc.