Validity of ICD-10-CM Codes Used to Identify Patients with Chronic Hepatitis B and C Virus Infection in Administrative Claims Data from the Taiwan National Health Insurance Outpatient Claims Dataset.

PURPOSE: To validate the use of International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes to identify patients with chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in the Taiwan National Health Insurance (NHI) Outpatient Claims Dataset. METHODS: We conducted a retrospective study using results of HBV surface antigen (HBsAg), HBV e antigen (HBeAg), and anti-HCV antibody tests in the NHI Lab & Exam Dataset from January 1 to March 31, 2018, as the reference standard to confirm HBV and HCV infection cases. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to assess the performance of HBV infection-specific ICD-10-CM codes (B180, B181, and B191) and HCV infection-specific ICD-10-CM codes (B182 and B192) recorded in the NHI Outpatient Claims Dataset to identify patients with HBV or HCV infection. RESULTS: In total, 196,635 and 120,628 patients had analyzable results for HBsAg/HBeAg tests and anti-HCV tests, respectively. Moreover, 44,574 and 14,443 were confirmed to have HBV and HCV infection, respectively. The sensitivity, specificity, PPV, and NPV were, respectively, 46%, 83%, 45%, and 84% for HBV infection-specific ICD-10-CM codes and 47%, 99%, 81%, and 93% for HCV infection-specific ICD-10-CM codes. The sensitivity demonstrated great variation by region, clinical setting, and physician specialty. CONCLUSION: The HBV and HCV infection-specific ICD-10-CM codes recorded by physicians in Taiwan NHI outpatient claims data in 2018 had moderate sensitivity and high specificity for both HBV and HCV infection. The PPV was high for HCV ICD-10-CM codes, yet moderate for HBV ICD-10-CM codes.

Leading causes of death among decedents with mention of schizophrenia on the death certificates in the United States.

BACKGROUND: Little is known about the changes in the ranking of leading cause of death (COD) among people died with schizophrenia across years in the United States (U.S.). This study aims to determine the ranking of leading COD among U.S. decedents with mention of schizophrenia by age from 2000 to 2015. METHODS: The mortality multiple COD files maintained by the National Center for Health Statistics were used to identify decedents aged 15 years old and above with mention of schizophrenia anywhere on the death certificates to determine the number and proportion of deaths attributed to various underlying CODs. RESULTS: Of 13,289, 13,655, 14,135, and 15,033 people who died in 2000-2003, 2004-2007, 2008-2011and 2012-2015 with mention of schizophrenia, similar to all decedents, heart disease and cancer was the first and the second leading COD throughout the study years. Schizophrenia ranked the third in most years except in 2004-2007. The first leading COD for decedents with mention of schizophrenia aged 15-24, 25-44, 45-64, 65-74, and 75+ years old in 2012-2015 was suicide, accidents, heart disease, heart disease, and Alzheimer's disease and related dementia, respectively. Nevertheless, it was accidents, accidents, cancer, cancer, and heart disease, respectively for all decedents. CONCLUSION: The ranking of leading CODs among U.S. decedents with mention of schizophrenia changed across years and differed from all decedents by age, which suggest that different interventions should be designed accordingly.

Trends in proportions of hospitals and operators not meeting minimum percutaneous coronary intervention volume standards in Taiwan, 2001-2013.

OBJECTIVE: To examine trends in proportions of hospitals and operators not meeting the minimum percutaneous coronary intervention (PCI) volume standards in Taiwan during 2001-2013. BACKGROUND: The 2013 Clinical Competence Statement recommends that operators perform a minimum of ≥50 PCIs annually (averaged over a 2-year period) in hospitals conducting ≥200 PCIs annually. METHODS: Taiwan National Health Insurance claims data from 2001 to 2013 are used to determine the annual numbers of PCIs performed by each hospital and operator. RESULTS: The percentage of hospitals conducting annual PCI volumes of <200 decreased from 57% (26/46) in 2001 to 39% (29/74) in 2007 and 33% (33/91) in 2013; the percentage of operators conducting PCI volumes <50 annually remained relatively constant at 60% (146/243) in 2001, 60% (270/452) in 2007, and 58% (354/611) in 2013; and the percentage of operators conducting low volumes (<50) in low-volume hospitals (<200) decreased from 24% (57/243) in 2001 to 15% (66/452) in 2007 and 12% (76/611) in 2013. CONCLUSIONS: Approximately one-third of hospitals and three-fifths of operators in Taiwan failed to meet minimum PCI volume standards. Further research examining patient outcomes from PCIs performed by low-volume hospitals and operators is recommended.