The effect of using ICD-10 or ICPC-2-R coding systems on primary health care service planning

Abstract

Objective: Coding systems are used to create an appropriate database for many areas in healthcare systems such as budgeting, clinical research, education, financial analysis, marketing, patient care, quality and risk management, statistics and strategy development. The aim of this study was to compare the ICD-10 and ICPC-2-R diagnostic codes according to the reasons of admission to family medicine outpatient clinics and discuss the effects of differences on service planning.

Methods: A total of 3172 patient files of 2146 women (67.7%) and 1026 men (32.3%)) who admitted to Yıldırım Beyazıt Training and Research Hospital Family Medicine outpatient clinic were included in the study. The reasons for referral of the patients, their socio-demographic characteristics, ICD‑10 and ICPC-2-R diagnostic codes were analyzed.

Results: 713 (22.48%) of the patients who have hypertension, which is a chronic disease, had I10 (essential hypertension) as their ICD-10 code. However, 91,02% of them applied for prescribing their drugs (n = 649) and 7.85% (n = 56) applied for blood tests or to consult blood results. When the acute disease diagnosis were evaluated, the most common ICD-10 diagnosis was J06.9 (acute upper respiratory tract infection). The reason of application of these patients were cough, sore throat and common cold and all patients were diagnosed with R74 (acute upper respiratory tract infection) as the ICPC-2-R diagnostic code.

Conclusion: As a result, it is seen that patients can apply to family medicine outpatient clinics with a variety of symptoms, complaints and wishes. Both classification systems are compatible with outpatient admissions for signs or symptoms of acute illness. However, ICD-10 is incompatible with the policlinic applications of the chronic patients’ needs such as ­control of the chronic condition, medication or social requests.