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What do community paediatricians do? The answer in 30 codes
  1. N Sellathurai1,
  2. G Siggers2,
  3. F Rahman3,
  4. A Bem4
  1. 1Community Paediatrics, Hounslow and Richmond NHS Trust, London, UK
  2. 2Community Paediatrics, Lewisham Healthcare NHS Trust, London, UK
  3. 3Community Paediatrics, Derbyshire Healthcare Foundation Trust, Derby, UK
  4. 4Community Paediatrics, Norfolk Community Health and Care, Norfolk, UK

Abstract

Aims To determine the most commonly used ICD 10 diagnostic codes in community paediatric caseloads in 4 areas (A B C D) in order to develop the BACCH (British Association of Community Child Health) informatics group list of top 30 ICD 10 codes, POPS-CC-30 v.1; this preliminary list was created after discussion by the BACCH informatics email group, which includes about 35 doctors.

Methods Historically, most outpatient based paediatric services have been not been able to assign diagnostic codes to their caseload. The British Association of Community Child Health informatics group has developed a basic list of 30 diagnostic codes common to ICD10, Read as well as SNOWMED CT systems that aims to cover most of the usual caseload in community paediatrics.

Output data was obtained from two different systems in 3 areas and used to select the top 30 codes for the BACCH list. Codes were grouped into five pathways: learning, behaviour, neurosensory, general and safeguarding. The list was also circulated to the informatics group for comments and final selection.

Results The full list of 30 codes grouped into five pathways with usage ranking in each of three areas will be presented. 90% of the diagnostic codes currently used in the four areas are included. Minor variations are to be expected across services depending on how much palliative/mental health work is done.

Conclusions Use of this basic list will enable comparative analysis of case mix by individual doctors for their appraisals, by clinical directors for service development and quality issues and by commissioners for developing PBR currencies and tariffs aligned to pathways. Such a list is simple enough to be used in paper form straightaway and does not require immediate IMT investment. Devising this list has already generated much interest and debate, e.g. on the use of developmental delay as a diagnostic category.

BACCH plans to develop a fuller list of 50 codes, in line with the recent AoRMC (Academy of Royal Medical Colleges) recommendations.

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