使用 Z 代码在电子病历中记录社会风险因素:范围审查。

IF 3.3 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Medical Care Pub Date : 2024-11-15 DOI:10.1097/MLR.0000000000002101
Kelley M Baker, Mary A Hill, Debora G Goldberg, Panagiota Kitsantas, Kristen E Miller, Kelly M Smith, Alicia Hong
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引用次数: 0

摘要

简介个人层面的社会风险因素对健康有重大影响。电子健康记录中可以使用 ICD-10 诊断代码("Z 代码")记录社会风险。本研究旨在总结有关使用 Z 代码记录社会风险的文献:我们使用 PubMed、Medline、CINAHL 和 Web of Science 数据库对 2024 年 6 月之前发表的论文进行了范围审查。如果研究是在同行评审期刊上以英文发表的,并报告了美国的 Z 代码使用率和数据,则会被纳入:共有 32 篇文章被纳入综述。在基于患者层面数据的研究中,患者人数从 558 人到 2.04 亿人不等,Z 代码使用率从 0.4% 到 17.6%,中位数为 1.2%。在检查病例数据的研究中,样本量从 19,000 到 21 亿病例不等,Z 代码使用率从 0.1% 到 3.7%,中位数为 1.4%。报告最多的 Z 代码是 Z59(住房和经济状况)、Z63(主要支持群体)和 Z62(成长环境)。有 Z 代码的患者更有可能是年轻人、男性、非白人、在城市教学机构就医、医疗费用和使用率较高:讨论:使用 Z 代码记录社会风险的比例较低。然而,对 Z 代码的研究兴趣正在增长,更好地了解 Z 代码的使用有利于制定增加社会风险记录的策略,从而改善健康结果。
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Using Z Codes to Document Social Risk Factors in the Electronic Health Record: A Scoping Review.

Introduction: Individual-level social risk factors have a significant impact on health. Social risks can be documented in the electronic health record using ICD-10 diagnosis codes (the "Z codes"). This study aims to summarize the literature on using Z codes to document social risks.

Methods: A scoping review was conducted using the PubMed, Medline, CINAHL, and Web of Science databases for papers published before June 2024. Studies were included if they were published in English in peer-reviewed journals and reported a Z code utilization rate with data from the United States.

Results: Thirty-two articles were included in the review. In studies based on patient-level data, patient counts ranged from 558 patients to 204 million, and the Z code utilization rate ranged from 0.4% to 17.6%, with a median of 1.2%. In studies that examined encounter-level data, sample sizes ranged from 19,000 to 2.1 billion encounters, and the Z code utilization rate ranged from 0.1% to 3.7%, with a median of 1.4%. The most reported Z codes were Z59 (housing and economic circumstances), Z63 (primary support group), and Z62 (upbringing). Patients with Z codes were more likely to be younger, male, non-White, seeking care in an urban teaching facility, and have higher health care costs and utilizations.

Discussion: The use of Z codes to document social risks is low. However, the research interest in Z codes is growing, and a better understanding of Z code use is beneficial for developing strategies to increase social risk documentation, with the goal of improving health outcomes.

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来源期刊
Medical Care
Medical Care 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.20
自引率
3.30%
发文量
228
审稿时长
3-8 weeks
期刊介绍: Rated as one of the top ten journals in healthcare administration, Medical Care is devoted to all aspects of the administration and delivery of healthcare. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of healthcare. This timely journal reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services.
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