Diagnosis Clusters for Emergency Medicine
Article first published online: 28 JUN 2008
© 2003 Society for Academic Emergency Medicine
Academic Emergency Medicine
Volume 10, Issue 12, pages 1337–1344, December 2003
How to Cite
Travers, D. A., Haas, S. W., Waller, A. E. and Tintinalli, J. E. (2003), Diagnosis Clusters for Emergency Medicine. Academic Emergency Medicine, 10: 1337–1344. doi: 10.1197/S1069-6563(03)00536-0
- Issue published online: 28 JUN 2008
- Article first published online: 28 JUN 2008
- Received October 8, 2002; revision received January 16, 2003; revision received May 10, 2003; accepted May 13, 2003.
- health services administration;
- information management;
- health services research;
- emergency medicine
Objectives: Aggregated emergency department (ED) data are useful for research, ED operations, and public health surveillance. Diagnosis data are widely available as The International Classification of Diseases, version, 9, Clinical Modification (ICD-9-CM) codes; however, there are over 24,000 ICD-9-CM code-descriptor pairs. Standardized groupings (clusters) of ICD-9-CM codes have been developed by other disciplines, including family medicine (FM), internal medicine (IM), inpatient care (Agency for Healthcare Research and Quality [AHRQ]), and vital statistics (NCHS). The purpose of this study was to evaluate the coverage of four existing ICD-9-CM cluster systems for emergency medicine. Methods: In this descriptive study, four cluster systems were used to group ICD-9-CM final diagnosis data from a southeastern university tertiary referral center. Included were diagnoses for all ED visits in July 2000 and January 2001. In the comparative analysis, the authors determined the coverage in the four cluster systems, defined as the proportion of final diagnosis codes that were placed into clusters and the frequencies of diagnosis codes in each cluster. Results: The final sample included 7,543 visits with 19,530 diagnoses. Coverage of the ICD-9-CM codes in the ED sample was: AHRQ, 99%; NCHS, 88%; FM, 71%; IM, 68%. Seventy-six percent of the AHRQ clusters were small, defined as grouping <1% of the diagnosis codes in the sample. Conclusions: The AHRQ system provided the best coverage of ED ICD-9-CM codes. However, most of the clusters were small and not significantly different from the raw data.