Coding for climate: sourcing better climate-health data from medical billing

S. Wheat, E. Sbiroli, M. Dunn, B. Chekuri, Amanda Millstein, Terry O'Connor, C. Rublee, J. Lemery, Vijay S. Limaye
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Abstract

While evidence points to climate change adversely impacting health and wellbeing, there remains a great need for more authoritative and actionable data that better describes the full magnitude and scope of this growing crisis. Given the uncertainty inherent to current detection and attribution studies, the improved specificity offered by the 10th revision of the International Classification of Diseases (ICD-10) coding of climate-sensitive health outcomes at the point of care may help to better quantify the connection between more intense and frequent extreme weather events and specific health sequela. With improved application of the available ICD-10 codes designed to capture climate-sensitive health outcomes, the ICD-10 system can function as a leading indicator. In this collaboration, publicly available ICD-10 code data was downloaded from Centers for Medicare and Medicaid Services archives and cross-referenced with 29 keywords (e.g. heat, hurricane, smoke, etc) determined by relevance to climate impacts on human health from consensus literature. We identified 46 unique ICD-10 codes for climate-sensitive health conditions. By highlighting the need for broader application of these codes and advocating for the development of new codes that better document the growing burden of climate-sensitive health outcomes, we hope to drive the development of more evidence-based, health-protective interdisciplinary climate action strategies across health systems.
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为气候编码:从医疗账单中获取更好的气候健康数据
虽然有证据表明气候变化对健康和福祉产生不利影响,但仍然非常需要更权威和可操作的数据,以更好地描述这一日益严重的危机的全部程度和范围。鉴于目前的检测和归因研究固有的不确定性,《国际疾病分类》(ICD-10)第10次修订提供的护理点气候敏感健康结果编码的改进特异性可能有助于更好地量化更强烈和频繁的极端天气事件与特定健康后遗症之间的联系。通过改进现有的旨在捕捉气候敏感健康结果的《国际疾病分类-10》代码的应用,《国际疾病分类-10》系统可以作为领先指标发挥作用。在这项合作中,从医疗保险和医疗补助服务中心的档案中下载了可公开获得的ICD-10代码数据,并与共识文献中根据与气候对人类健康影响的相关性确定的29个关键词(如热、飓风、烟雾等)进行了交叉对照。我们为气候敏感型健康状况确定了46个独特的ICD-10代码。我们强调需要更广泛地应用这些准则,并倡导制定新的准则,以便更好地记录气候敏感型卫生结果带来的日益沉重的负担。我们希望通过这些准则,推动整个卫生系统制定更多以证据为基础、保护健康的跨学科气候行动战略。
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