Resumen

VICENTE-FATELA, L. et al. Codification of chronic pain with the international classification of diseases - 9 th revision : clinical modification (ICD 9-CM). Rev. Soc. Esp. Dolor [online]. 2007, vol.14, n.2, pp.95-103. ISSN 1134-8046.

Introduction: In 1988, the National Health Institute (INSALUD) in Spain started up the project CÓDIGO, in order to establish on a voluntary basis the necessary collection of data to cover a Minimum Basic Data Set (CMBD) as well as the codification with the International Classification of Diseases -9th revisión - Clinical Modification (ICD-9-MC). This collection of basic data is the first necessary step for the homologation of all the hospital activity data in Spain as well as in the European environment. The aim was to obtain comprehensible and reliable information on the results of the health user-system interaction in order to ensure quality. The adoption of methods to measure hospital final products based on clinical variables is considered essential for current management and planning. Although it is not the only available one, the cluster system of Diagnosis Related Groups (DRGs) is the most universally accepted. The first requirement to be able to assign DRGs is obtaining reports codified according to the ICD-9-MC. Objective: The objective of this work is to present the results obtained after adapting the ICD-9-MC international norms of codification for chronic pain carried out in our Chronic Pain Unit. Material and methods: In 2000 our hospital adopted the HP-HIS (Hewlett-Packard- Hospital Integral System), a computer system of hospital activity collection. In May 2002 our Unit was incorporated to this procedure, and we started to codify the diagnoses and procedures from the patients undergoing therapeutic techniques or surgery. The only code system accepted in Spain is the ICD-9-MC. Specific codes of chronic pain do not exist in the ICD-9-MC, so that each diagnosis code has been obtained looking for the one that better describes the pain diagnosis that needs to be codified. In the four year period between May 2002 and April 2006, both inclusive, the clinical records of patients attended have been reviewed to obtain the necessary data to carry out the codification. For each diagnosis, a main code and if necessary a second code are assigned, as well as a procedure code. Results: In the four year period between May 2002 and April 2006, both inclusive, 5393 patients records have been codified. It has been possible to codify 100% of the diagnoses, and to créate a datábase that gathers more than 150 diagnoses with their corresponding codes according to the ICD-9-MC. The implementation of the codification system has permitted the classification of pathologies by means of DRGs. The most frequent DRG has been number 243, described as "Medical pathology of spine" that included 40-50% of cases depending of the year. Conclusions: The normalization of the criteria for use of the ICD-9-MC, requires the necessary education of professionals implementing this codification system. In these moments the codification of our patients has allowed us the incorporation to the code system HP-HIS (Hewlett-Packard- Hospital Integral System) and it represents an improvement for the administration of the Unit facilitating clinical studies, epidemiological surveys, morbidity, mortality and investigation and financing for processes (DRG) studies. Nevertheless, our experience and that of other peer groups will be necessary to achieve excellence in the process of codification for Chronic Pain.

Palabras clave : Codification; ICD-9-MC; Chronic pain; DRG.

        · resumen en Español     · texto en Español     · Español ( pdf )