Soins maternels intensifs (Maternal Intensive Care) en Belgique - KCE

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46 Maternal Intensive Care in Belgium KCE Reports 94 D. Ten most frequent ICD-9-CM codes by mode of delivery As mentioned in the methodology section, each woman has only one main diagnosis, but can have more than one secondary diagnosis. For the 97,718 pregnant women in the database, we have 225,404 diagnostic codes as secondary diagnosis 39 , The detailed frequencies of these codes are presented in the tables underneath (V-codes excluded). Table 14: 10 most frequent 40 ICD-9-CM codes Vaginal delivery (N=78,694) - Main diagnosis - Specialty 1 41 Naming of icd9 icd9 Number Proportion Delivery in a completely normal case 650 17,959 22.8% First-degree perineal laceration during delivery 66401 4,882 6.2% Prolonged pregnancy, unspecified as to episode of care 64511 4,060 5.2% Early onset of delivery 64421 2,002 2.5% Other & unspecified cord entanglement, without mention of compression, complicating labor & delivery 66331 1,970 2.5% Second-degree perineal laceration during delivery 66411 1,769 2.2% Forceps or vacuum extractor delivery without mention of indication 66951 1,720 2.2% Cord around neck, with compression, complicating labor & delivery 66311 1,631 2.1% Fetal distress 65631 1,576 2.0% Premature rupture of membranes 65811 Source: Merged IMA and MKG/RCM Data 01/10/2003 – 30/09/2004 1,553 2.0% Table 15: 10 most frequent 42 ICD-9-CM codes Vaginal delivery (N=78,694) - Secondary diagnoses – Specialty 1 Naming of icd9 icd9 Number Proportion First-degree perineal laceration during delivery 66401 3,287 4.2% Streptococcus B infection 04102 3,186 4.0% Other & unspecified cord entanglement, without mention of compression, complicating labor & delivery 66331 2,313 2.9% Prolonged pregnancy, unspecified as to episode of care 64511 2,169 2.8% Anemia 64822 2,086 2.7% Tobacco use disorder 3051 1,992 2.5% Anemia, unspecified 2859 1,909 2.4% Anemia complicating pregnancy, childbirth, or the puerperium 64821 1,635 2.1% Other current conditions classifiable elsewhere 64891 1,530 1.9% Cord around neck, with compression, complicating labor & delivery 66311 1,511 1.9% Source: Merged IMA and MKG/RCM Data 01/10/2003 – 30/09/2004 39 from which 51.06 % are V-codes and D-codes. 40 The 10 most frequent ICD-9 codes total 39,112 out of 78,694 41 Information from the doctor who manages the medical file (specialist nr 1) 42 The 10 most frequent ICD-9 codes total 21,618 out of 78,694
KCE Reports 94 Maternal Intensive Care in Belgium 47 Table 16: 10 most frequent 43 ICD-9-CM codes C-section (N=18,164) - Main diagnosis – Specialty 1 Naming of icd9 Uterine scar from previous surgery icd9 Number Proportion complicating pregnancy, childbirth, or the puerperium 65421 1,978 10.9% Breech presentation without mention of version 65221 1,838 10.1% Obstruction caused by malposition of fetus at onset of labor 66001 1,190 6.6% Obstruction by bony pelvis 66011 1,074 5.9% Fetopelvic disproportion 65341 1,032 5.7% Fetal distress 65631 913 5.0% Cesarean delivery, without mention of indication 66971 896 4.9% Obstruction by abnormal pelvic soft tissues 66021 505 2.8% Generally contracted pelvis 65311 496 2.7% Early onset of delivery 64421 418 2.3% Source: Merged IMA and MKG/RCM Data 01/10/2003 – 30/09/2004 Table 17: 10 most frequent 44 ICD-9-CM codes C-section (N=18,164) - Secondary diagnosis – Specialty 1 Naming of icd9 Uterine scar from previous surgery icd9 Number Proportion complicating pregnancy, childbirth, or the puerperium 65421 2,227 12.3% Breech presentation without mention of version 65221 1,577 8.7% Early onset of delivery 64421 1,302 7.2% Fetopelvic disproportion 65341 1,026 5.6% Anemia 64822 976 5.4% Fetal distress 65631 957 5.3% Anemia 64821 746 4.1% Prolonged pregnancy, unspecified as to episode of care 64511 707 3.9% Generally contracted pelvis 65311 698 3.8% Infections of genitourinary tract in pregnancy 64661 644 3.5% Source: Merged IMA and MKG/RCM Data 01/10/2003 – 30/09/2004 E. Transfers Among the 97,718 pregnant women in our database, 992(1.02%) were transferred from one hospital to another. These women account for 1,073 transfers, 68 women were transferred more than twice. Among these 1,073 transfers, 660 (61.5%) occur before the delivery and 413 (38.5%) after the delivery. These figures are similar to those provided by the FPS yearly statistics (most recent report published in 2001). The 2001 file provided totalize 1,050 transferred women on 118,247 deliveries (0.9% of women transferred). 43 The 10 most frequent ICD-9 codes total 10,340 out of 18,164 44 The 10 most frequent ICD-9 codes total 10,086 out of 18,164
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35. Etude relative aux coûts poten
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