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Title

Concordance between the Clinical Definition of Polypathological Patient versus Automated Detection by Means of Combined Identification through ICD-9-CM Codes

AuthorsGómez-Salgado, Juan; Bernabeu Wittel, Máximo; Aguilera-González, Carmen; Goicoechea-Salazar, Juan Antonio; Larrocha, Daniel; Nieto Martín, M. D.; Moreno-Gaviño, L.; Ollero Baturone, M.
KeywordsCost effectiveness
Multiple chronic conditions
Population health management
Patient safety
Multimorbidity
Polypathological patient
CD-9-CM
Issue Date6-May-2019
PublisherMultidisciplinary Digital Publishing Institute
CitationJournal of Clinical Medicine 8(5): 613 (2019)
AbstractIt is unknown whether the digital application of automated ICD-9-CM codes recorded in the medical history are useful for a first screening in the detection of polypathological patients. In this study, the objective was to identify the degree of intra- and inter-observer concordance in the identification of in-patient polypathological patients between the standard clinical identification method and a new automatic method, using the basic minimum data set of ICD-9-CM codes in the digital medical history. For this, a cross-sectional multicenter study with 1518 administratively discharged patients from Andalusian hospitals during the period of 2013–2014 has been carried out. For the concordance between the clinical definition of a polypathological patient and the polypathological patient classification according to ICD-9-CM coding, a 0.661 kappa was obtained (95% confidence interval (CI); 0.622–0.701) with p < 0.0001. The intraclass correlation coefficient between both methods for the number of polypathological patient categories was 0.745 (95% CI; 0.721–0.768; p < 0.0001). The values of sensitivity, specificity, positive-, and negative predictive values of the automated detection using ICD-9-CM coding were 78%, 88%, 78%, and 88%, respectively. As conclusion, the automatic identification of polypathological patients by detecting ICD-9-CM codes is useful as a screening method for in-hospital patients.
DescriptionThis article belongs to the Section Epidemiology & Public Health.
Publisher version (URL)https://doi.org/10.3390/jcm8050613
URIhttp://hdl.handle.net/10261/212975
DOIhttp://dx.doi.org/10.3390/jcm8050613
E-ISSN2077-0383
Appears in Collections:(IBIS) Artículos
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