1
|
Abou-ElWafa H, El-Gilany AH. Acute diseases: An epidemiologic perspective. JOURNAL OF ACUTE DISEASE 2023. [DOI: 10.4103/2221-6189.369072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
|
2
|
Sanusi RA, Yan L, Hamad AF, Ayilara OF, Vasylkiv V, Jozani MJ, Banerji S, Delaney J, Hu P, Wall-Wieler E, Lix LM. Transitions between versions of the International Classification of Diseases and chronic disease prevalence estimates from administrative health data: a population-based study. BMC Public Health 2022; 22:701. [PMID: 35397596 PMCID: PMC8994899 DOI: 10.1186/s12889-022-13118-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 03/30/2022] [Indexed: 11/10/2022] Open
Abstract
Background Diagnosis codes in administrative health data are routinely used to monitor trends in disease prevalence and incidence. The International Classification of Diseases (ICD), which is used to record these diagnoses, have been updated multiple times to reflect advances in health and medical research. Our objective was to examine the impact of transitions between ICD versions on the prevalence of chronic health conditions estimated from administrative health data. Methods Study data (i.e., physician billing claims, hospital records) were from the province of Manitoba, Canada, which has a universal healthcare system. ICDA-8 (with adaptations), ICD-9-CM (clinical modification), and ICD-10-CA (Canadian adaptation; hospital records only) codes are captured in the data. Annual study cohorts included all individuals 18 + years of age for 45 years from 1974 to 2018. Negative binomial regression was used to estimate annual age- and sex-adjusted prevalence and model parameters (i.e., slopes and intercepts) for 16 chronic health conditions. Statistical control charts were used to assess the impact of changes in ICD version on model parameter estimates. Hotelling’s T2 statistic was used to combine the parameter estimates and provide an out-of-control signal when its value was above a pre-specified control limit. Results The annual cohort sizes ranged from 360,341 to 824,816. Hypertension and skin cancer were among the most and least diagnosed health conditions, respectively; their prevalence per 1,000 population increased from 40.5 to 223.6 and from 0.3 to 2.1, respectively, within the study period. The average annual rate of change in prevalence ranged from -1.6% (95% confidence interval [CI]: -1.8, -1.4) for acute myocardial infarction to 14.6% (95% CI: 13.9, 15.2) for hypertension. The control chart indicated out-of-control observations when transitioning from ICDA-8 to ICD-9-CM for 75% of the investigated chronic health conditions but no out-of-control observations when transitioning from ICD-9-CM to ICD-10-CA. Conclusions The prevalence of most of the investigated chronic health conditions changed significantly in the transition from ICDA-8 to ICD-9-CM. These results point to the importance of considering changes in ICD coding as a factor that may influence the interpretation of trend estimates for chronic health conditions derived from administrative health data. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13118-8.
Collapse
|
3
|
Hamad AF, Vasylkiv V, Yan L, Sanusi R, Ayilara O, Delaney JA, Wall-Wieler E, Jozani MJ, Hu P, Banerji S, Lix LM. Mapping three versions of the international classification of diseases to categories of chronic conditions. Int J Popul Data Sci 2021; 6:1406. [PMID: 34007901 PMCID: PMC8104065 DOI: 10.23889/ijpds.v6i1.1406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Administrative health data capture diagnoses using the International Classification of Diseases (ICD), which has multiple versions over time. To facilitate longitudinal investigations using these data, we aimed to map diagnoses identified in three ICD versions - ICD-8 with adaptations (ICDA-8), ICD-9 with clinical modifications (ICD-9-CM), and ICD-10 with Canadian adaptations (ICD-10-CA) - to mutually exclusive chronic health condition categories adapted from the open source Clinical Classifications Software (CCS). METHODS We adapted the CCS crosswalk to 3-digit ICD-9-CM codes for chronic conditions and resolved the one-to-many mappings in ICD-9-CM codes. Using this adapted CCS crosswalk as the reference and referring to existing crosswalks between ICD versions, we extended the mapping to ICDA-8 and ICD-10-CA. Each mapping step was conducted independently by two reviewers and discrepancies were resolved by consensus through deliberation and reference to prior research. We report the frequencies, agreement percentages and 95% confidence intervals (CI) from each step. RESULTS We identified 354 3-digit ICD-9-CM codes for chronic conditions. Of those, 77 (22%) codes had one-to-many mappings; 36 (10%) codes were mapped to a single CCS category and 41 (12%) codes were mapped to combined CCS categories. In total, the codes were mapped to 130 adapted CCS categories with an agreement percentage of 92% (95% CI: 86%-98%). Then, 321 3-digit ICDA-8 codes were mapped to CCS categories with an agreement percentage of 92% (95% CI: 89%-95%). Finally, 3583 ICD-10-CA codes were mapped to CCS categories; 111 (3%) had a fair or poor mapping quality; these were reviewed to keep or move to another category (agreement percentage = 77% [95% CI: 69%-85%]). CONCLUSIONS We developed crosswalks for three ICD versions (ICDA-8, ICD-9-CM, and ICD-10-CA) to 130 clinically meaningful categories of chronic health conditions by adapting the CCS classification. These crosswalks will benefit chronic disease studies spanning multiple decades of administrative health data.
Collapse
Affiliation(s)
- Amani F. Hamad
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada, R3E0T6
| | - Viktoriya Vasylkiv
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada, R3E0T6
| | - Lin Yan
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada, R3E0T6
| | - Ridwan Sanusi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada, R3E0T6
| | - Olawale Ayilara
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada, R3E0T6
| | - Joseph A. Delaney
- College of Pharmacy, University of Manitoba, Winnipeg, Manitoba, Canada, R3E0T5; Department of Epidemiology, University of Washington, Seattle, Washington, USA, WA 98195
| | - Elizabeth Wall-Wieler
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada, R3E0T6
| | | | - Pingzhao Hu
- Department of Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, Manitoba, Canada, R3E0J9
| | - Shantanu Banerji
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada, R3A1R9; Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada, R3E0V9
| | - Lisa M. Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada, R3E0T6
| |
Collapse
|
4
|
The morbidity burden from emergency conditions in Jimma city, Southwest Ethiopia. Int Emerg Nurs 2020; 55:100874. [PMID: 32475801 DOI: 10.1016/j.ienj.2020.100874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 03/21/2020] [Accepted: 04/17/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Sub-Saharan Africa shares a disproportionately large ratio of the global acute disease burden, however epidemiological data specific to the burden of emergency conditions are lacking. This study aimed to determine the morbidity burden of emergency conditions in Jimma city, Southwest Ethiopia. METHODS A cross-sectional study was conducted using emergency case registries of three years from 2014 to 2017, at Jimma Medical Center and Shenen Gibe Hospital. 39,537 emergency visits were included in the study. The data were exported to SPSS V.23.0 for statistical analysis, descriptive analysis was used to summarize demographic characteristics, causes of visit, and morbidity rates. Findings were integrated with population-based health demographic reports quantifying the morbidity burden. Outcome measures were overall number of emergency visits and morbidity rates for the population groups. RESULTS From a total of 39,537 visits, those between 15 and 29 years of age accounted for 42.1% (n = 16615), and 50.6% (n = 20004) were females. Communicable, Maternal, Neonatal and Nutritional (CMNNs) conditions accounted for 57.2%(n = 22597), followed by injuries (22.9%, n = 9055). Top five conditions were non-specific trauma (2.3%, n = 4861), complicated labor (8.4%, n = 3320), lower respiratory infections (8.1%, n = 3213), acute febrile illness (6.6%, n = 2600), and neonatal infections (3.7%, n = 1444). CONCLUSION The burden of acute conditions presented to public hospitals in Jimma city is high. Traumatic injuries, obstetric emergencies, lower respiratory infections, and neonatal emergencies were the most frequent causes of acute visits. An appropriate emergency care system that addresses this high burden of acute emergencies should be established in the study area.
Collapse
|
5
|
Bruno E, White MC, Baxter LS, Ravelojaona VA, Rakotoarison HN, Andriamanjato HH, Close KL, Herbert A, Raykar N, Saluja S, Shrime MG. An Evaluation of Preparedness, Delivery and Impact of Surgical and Anesthesia Care in Madagascar: A Framework for a National Surgical Plan. World J Surg 2017; 41:1218-1224. [PMID: 27905017 DOI: 10.1007/s00268-016-3847-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND The Lancet Commission on Global Surgery (LCoGS) described the lack of access to safe, affordable, timely surgical, and anesthesia care. It proposed a series of 6 indicators to measure surgery, accompanied by time-bound targets and a template for national surgical planning. To date, no sub-Saharan African country has completed and published a nationwide evaluation of its surgical system within this framework. METHOD Mercy Ships, in partnership with Harvard Medical School and the Madagascar Ministry of Health, collected data on the 6 indicators from 22 referral hospitals in 16 out of 22 regions of Madagascar. Data collection was by semi-structured interviews with ministerial, medical, laboratory, pharmacy, and administrative representatives in each region. Microsimulation modeling was used to calculate values for financial indicators. RESULTS In Madagascar, 29% of the population can access a surgical facility within 2 h. Surgical workforce density is 0.78 providers per 100,000 and annual surgical volume is 135-191 procedures per 100,000 with a perioperative mortality rate of 2.5-3.3%. Patients requiring surgery have a 77.4-86.3 and 78.8-95.1% risk of incurring impoverishing and catastrophic expenditure, respectively. Of the six LCoGS indicator targets, Madagascar meets one, the reporting of perioperative mortality rate. CONCLUSION Compared to the LCoGS targets, Madagascar has deficits in surgical access, workforce, volume, and the ability to offer financial risk protection to surgical patients. Its perioperative mortality rate, however, appears better than in comparable countries. The government is committed to improvement, and key stakeholder meetings to create a national surgical plan have begun.
Collapse
Affiliation(s)
- Emily Bruno
- M/V Africa Mercy, Mercy Ships, Port of Toamasina, Madagascar.,University of Tennessee Health Science Center College of Medicine, Memphis, TN, USA.,Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Michelle C White
- M/V Africa Mercy, Mercy Ships, Port of Toamasina, Madagascar. .,M/V Africa Mercy, Mercy Ships, Port of Cotonou, Benin.
| | - Linden S Baxter
- M/V Africa Mercy, Mercy Ships, Port of Toamasina, Madagascar
| | | | | | | | - Kristin L Close
- M/V Africa Mercy, Mercy Ships, Port of Toamasina, Madagascar.,M/V Africa Mercy, Mercy Ships, Port of Cotonou, Benin
| | - Alison Herbert
- M/V Africa Mercy, Mercy Ships, Port of Toamasina, Madagascar
| | - Nakul Raykar
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.,Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Saurabh Saluja
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.,Department of Surgery, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA
| | - Mark G Shrime
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.,Department of Otolaryngology, Harvard Medical School, Boston, MA, USA.,Office of Global Surgery and Health, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| |
Collapse
|
6
|
Kannan VC, Ramalanjaona G, Andriamalala CN, Reynolds TA. The clinical practice of emergency medicine in Mahajanga, Madagascar. Afr J Emerg Med 2016; 6:5-11. [PMID: 30456057 PMCID: PMC6233243 DOI: 10.1016/j.afjem.2015.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 11/20/2015] [Accepted: 12/02/2015] [Indexed: 11/26/2022] Open
Abstract
Introduction Little is documented concerning the clinical practice of emergency care in low- and middle-income countries. The lack of structural models presents serious obstacles to the development of effective emergency care services. This study provides such a model by describing the clinical practice at the emergency centre of the Centre Hôpitalier Universitaire de Mahajanga in Madagascar. Methods This was a retrospective chart review of all adult patients presenting to the emergency centre from September to November 2012. Archived chart data were extracted into a computer database. Data included: age, sex, date, diagnostic investigations, procedures, medications, and diagnosis. Results 727 charts were reviewed, averaging eight patients per day. The three most frequent pathologies observed were trauma, gastrointestinal, and infectious disease. A total of 392 received diagnostic investigations. These were chiefly complete blood counts (n = 218), blood glucose (n = 155) and ECG (n = 92). Chest X-rays (n = 83), extremity X-rays (n = 55) and skull/face X-rays (n = 44) comprised the most common imaging. Ultrasounds were primarily abdominal (n = 9), renal/genitourinary (n = 6), and obstetric (n = 2). Therapeutic interventions were performed in 564 patients, most commonly intravenous access (n = 452) and wound/orthopaedic care (n = 185). Medications were administered to 568 patients, mostly anti-inflammatory/analgesics (n = 463) and antibiotics (n = 287). Conclusion This is the first descriptive study of the clinical practice of emergency medicine in Mahajanga, Madagascar. It provides both the Malagasy and international medical communities with an objective analysis of the practice of emergency care in Madagascar from both diagnostic and therapeutic standpoints. Emergency care here focuses on the management of traumatic injury and infectious disease. The diagnostic imaging, pharmacologic and procedural therapeutic interventions reflect the burdens placed upon this institution by these diseases. We hope this study will provide guidance for the further development of Malagasy-specific emergency care systems.
Collapse
Affiliation(s)
- Vijay C. Kannan
- University of Texas Southwestern, Division of Emergency Medicine, Dallas, TX, USA
- Department of Emergency Medicine, Maricopa Medical Center, Phoenix, AZ, USA
- Correspondence to Vijay C. Kannan.
| | | | | | - Teri A. Reynolds
- Emergency Medicine Department, Muhimbili National Hospital, Dar Es Salaam, Tanzania
- University of California San Francisco, Emergency Medicine and Global Health Sciences, CA, USA
| |
Collapse
|