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Transition to ICD-10: Impact on Australian deaths data. Malinda Steenkamp Research Centre for Injury Studies, Flinders University of South Australia Incorporating the AIHW National Injury Surveillance Unit. Background. Transition to ICD-10 (from 1999 for deaths) - PowerPoint PPT Presentation
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Transition to ICD-10: Impact on Australian deaths data
Malinda SteenkampResearch Centre for Injury Studies,
Flinders University of South AustraliaIncorporating the AIHW National Injury Surveillance Unit
Research Centre for Injury Studies, May 2002
2
Background
Transition to ICD-10 (from 1999 for deaths)
Impact on reporting national data?
Dual-coded deaths data1997 and 1998 (16,000 cases)
Trends Comparability ratios
external cause groupings + subgroups
Case flows
Research Centre for Injury Studies, May 2002
3
Major groups of external causes: Trends - all injury
0
10
20
30
40
50
60
70
80
90
100
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
Year of Death Registration
Ag
e-s
tan
da
rdis
ed
ra
te p
er
10
0,0
00
Males ICD-9
Females ICD-9Persons ICD-9
Males ICD-10
Females ICD-10Persons ICD-10
Research Centre for Injury Studies, May 2002
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Major groups of external causes: CRsMajor external cause group ICD-9
countsICD-10counts
CR(a) USACR(b)
Transportation (ICD-9: E800-E848; ICD-10: V01-V99) 3,972 4,024 1.01 1.03
Drowning (ICD-9: E910; ICD-10: W65-W74) 521 528 1.01 1.00
Poisoning due to pharmaceuticals (ICD-9: E850-E858; ICD-10: X40-X44)
888 926 1.04 0.84
Poisoning due to other substances (ICD-9: E860-E869; ICD-10: X45-X49)
83 85 1.02 1.00
Fires/burns/scalds (ICD-9: E890-E899, E924/0,8,9; ICD-10: X00-X19) 244 245 1.00 1.00
Falls (ICD-9 E880-E888; ICD-10 W00-W10) 2,307 913 0.40 0.97
Other unintentional (Remaining codes of ICD-9/ICD-10) 1,187 2,793 2.35 1.00
Intentional, self inflicted (ICD-9: E950-E959; ICD-10: X60-X84,Y87.0) 5,406 5,405 1.00 NR
Intentional, inflicted by another (ICD-9: E960-E978; E990-E999;ICD-10: X85-Y09, Y67.1, Y35-Y36, Y89.0, Y39.1)
650 651 1.00 NR
Undetermined intent (ICD-9: E980-E989; ICD-10: Y10-Y34,Y87.2) 255 266 1.04 NR
Medical misadventure, etc.ICD-9: E870-E879, E930-E949; YICD-10: 40-Y84,Y88.0-Y88.3)
170 243 1.43 NR
No external cause as UCoD 240,689 240,473 1.00 NR
All injuries (ICD-9: E800-E999; ICD-10: V01-Y98) 15,683 16,079 1.03 NR
Sources: (a) Calculated by NISU
(b) (Anderson, Minino et al. 2001)
Shaded areas indicate CR outside the arbitrary range 0.95 and 1.05.
Research Centre for Injury Studies, May 2002
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Falls (E880-E888) persons 65+ years
0
10
20
30
40
50
60
70
80
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Year of death registration
Ag
e-s
tan
da
rdis
ed
ra
te p
er
10
0,0
00
p
op
ula
tio
n
Males ICD-9
Females ICD-9
Persons ICD-9
Males ICD-10
Females ICD-10
Persons ICD-10
Research Centre for Injury Studies, May 2002
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Falls: Case flows
Accidental Falls
E880-E886
E888Other andunspecifiedfall
E887Fracture,causeunspecified
Other Unintentional Injury
E900-E909E911-E923E924.1E925-E929
ICD-9
Accidental Falls Other Unintentional Injury
W18Other fall onsame level
W19UnspecifiedFall
X59Exposuretounspecifiedfactor
W20-W64W75-W99X20-X39X50-X58Y85-Y86Y89.9
W00-W17
ICD-10
Research Centre for Injury Studies, May 2002
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Adjusted trends falls - persons 65+ yrs
0
10
20
30
40
50
60
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
Year of death registration
Ag
e-s
tan
dar
dis
ed
rat
e p
er
100,
000 ICD-9 Falls (E880-E888)
ICD-10 Falls (W00-W19)
ICD-10 Falls (W00-W19 AND X59 + #s)
Research Centre for Injury Studies, May 2002
8
Injury matrix - Unintentional categories
Mechanism ICD-9 ICD-10 CR
Cut/pierce 27 13 0.48Drowning 591 528 0.89Fall (I9: E880-E886, E888; I10 W00-W19) 890 913 1.03Fire/burn 244 245 1.00Firearm 40 41 1.03Machinery 111 65 0.59Motor vehicle traffic 3,532 3,448 0.98Pedal cyclist, other 13 22 1.69Pedestrian, other 87 131 1.51Transport, other 268 423 1.58Natural /environmental 103 106 1.03Poisoning 971 1,011 1.04Struck by/against 134 125 0.93Suffocation 329 402 1.22Other specified, classifiable 252 202 0.80Other specified, nec 15 114 7.60Unspecified 1,594 1,724 1.08All unintentional 9,201 9,513 1.03
Research Centre for Injury Studies, May 2002
9
Injury matrix - Suicide
Mechanism ICD-9 ICD-10 CR
Cut/pierce 101 101 1.00Drowning 123 123 1.00Fall 213 213 1.00Fire/burn 63 63 1.00Firearm 564 564 1.00All transportation 23 23 1.00Poisoning 1,876 1,876 1.00Suffocation 2,204 2,204 1.00Other specified, classifiable 212 175 0.83Other specified, nec 8 44 5.50Unspecified 19 19 1.00All suicide 5,406 5,405 0.99
Research Centre for Injury Studies, May 2002
10
Injury matrix - Homicide
Mechanism ICD-9 ICD-10 CRCut/pierce 200 197 0.99Drowning 10 10 1.00Fall 5 5 1.00Fire/burn 12 13 1.08Firearm 136 136 1.00All transportation 4 ..Poisoning 22 22 1.00Struck by/against 133 132 0.99Suffocation 52 53 1.02Other specified, classifiable 10 11 1.10Other specified, nec 14 8 0.57Unspecified 42 46 1.10All homicide 636 637 1.00
Research Centre for Injury Studies, May 2002
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Injury matrix - Undetermined
Mechanism ICD-9 ICD-10 CR
Cut/pierce 1 1 1.00Drowning 19 19 1.00Fall 9 10 1.11Fire/flame 6 6 1.00Firearm 10 11 1.10All Transportation 2 3 1.50Poisoning 179 187 1.04Suffocation 7 8 1.14Other specified, classifiable 9 10 1.11Other specified, nec 7 3 0.43Unspecified 6 9 1.50All undetermined 255 267 1.05
Legal intervention - firearm 14 14 1.00
All injury 15,682 16,079 1.03
Research Centre for Injury Studies, May 2002
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Main points• ICD-10 results in 3% increase in overall case counts
+515, - 119; net = 369
• Falls (ICD-9 E880-E888) - particular problems No equivalent to E887 - often used for persons aged 65+ yrs Most E887 shift to X59 Proposed solution - X59 + ‘Fractures’
• Injury matrix 10 of 17 Unintentional categories - some problems Less problems for suicide (and homicide) Undetermined - some problems but small numbers
Research Centre for Injury Studies, May 2002
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Major groups of external causes: CRsMajor external cause group ICD-9
case countsICD-10
case countsCR(a) USA (b)
Transportation 3,972 4,024 1.01 1.03
Drowning (excl water transport) 521 528 1.01 1.00
Poisoning due to pharmaceuticals 888 926 1.04 0.84
Poisoning due to other substances 83 85 1.02 1.00
Fires/burns/scalds 244 245 1.00 1.00
Falls (ICD-9 E880-E888; ICD-10 W00-W10) 2,307 913 0.40 0.97
Other unintentional 1,187 2,793 2.35 1.00
Intentional, self inflicted 5,406 5,405 1.00 NR
Intentional, inflicted by another 650 651 1.00 NR
Undetermined intent 255 266 1.04 NR
Medical misadventure, etc. 170 243 1.43 NR
No external cause as UCoD 240,689 240,473 1.00 NR
All injuries 15,683 16,079 1.03 NRSources: (a) Calculated by NISU(b) (Anderson, Minino et al. 2001)
