Moving Beyond International Classification of Diseases Codes for the Retrospective Identification of Gender Diverse Veterans.

IF 3.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH LGBT health Pub Date : 2024-04-24 DOI:10.1089/lgbt.2023.0327

Frank DeVone, Eric Jutkowitz, Christopher Halladay, M. Kauth, Alicia J Cohen, Jack Tsai

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Abstract

Purpose: The Veterans Health Administration (VHA) systematically asks Veterans to self-report gender identity for documentation in their electronic health record. Veterans with transgender and gender diverse (TGD) identities experience higher rates of several health conditions compared to Veterans without minoritized gender identities. Historically, cohorts of TGD Veterans were built with International Classification of Diseases Version 10 (ICD-10) codes assigned during clinical encounters. We examined concordance between self-reported gender identity and relevant ICD-10 codes in VHA health records to inform use of these indicators for examining the health needs of TGD Veterans. Methods: TGD-related ICD-10 codes were compared to self-reported gender identity from more than 1.5 million Veterans (2019-2022). Results: Only 34% of TGD Veterans included through self-report had an ICD-10 code associated with transgender care. ICD-10 codes had low sensitivity and high specificity compared to self-reported gender. Conclusion: These findings suggest ICD-10 codes alone undercount the larger population of TGD Veterans in the VHA.

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超越国际疾病分类代码，对不同性别退伍军人进行回顾性识别。

目的：退伍军人健康管理局（VHA）系统地要求退伍军人自我报告性别身份，以便在电子健康记录中进行记录。与没有性别认同的退伍军人相比，具有变性和性别多元化（TGD）身份的退伍军人患多种健康疾病的比例较高。从历史上看，TGD 退伍军人队列是根据临床会诊时分配的国际疾病分类第 10 版（ICD-10）代码建立的。我们检查了退伍军人健康记录中自我报告的性别认同与相关 ICD-10 代码之间的一致性，以便为使用这些指标来检查 TGD 退伍军人的健康需求提供参考。方法：将 TGD 相关 ICD-10 代码与 150 多万退伍军人（2019-2022 年）自我报告的性别认同进行比较。结果：在通过自我报告纳入的 TGD 退伍军人中，只有 34% 的人拥有与变性护理相关的 ICD-10 代码。与自我报告的性别相比，ICD-10 代码的灵敏度较低，特异性较高。结论：这些研究结果表明，ICD-10 代码本身并未充分统计出退伍军人事务部中更多的 TGD 退伍军人。

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来源期刊

LGBT health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -

CiteScore

6.60

自引率

6.20%

发文量

期刊介绍： LGBT Health is the premier peer-reviewed journal dedicated to promoting optimal healthcare for millions of sexual and gender minority persons worldwide by focusing specifically on health while maintaining sufficient breadth to encompass the full range of relevant biopsychosocial and health policy issues. This Journal aims to promote greater awareness of the health concerns particular to each sexual minority population, and to improve availability and delivery of culturally appropriate healthcare services. LGBT Health also encourages further research and increased funding in this critical but currently underserved domain. The Journal provides a much-needed authoritative source and international forum in all areas pertinent to LGBT health and healthcare services. Contributions from all continents are solicited including Asia and Africa which are currently underrepresented in sex research.