Engaging the allergy community: what the ICD-11 can bring us?
Data are presented here for the 406 respondents (Table 1) from 74
countries who completed the survey (Figure 1). The countries were
aggregated according to the six WHO global regions – AFRO (primarily
sub-Saharan Africa), PAHO (the Americas), EMRO (Eastern
Mediterranean/North Africa), EURO (Europe), SEARO (Southeast Asia), and
WPRO (Western Pacific) – and across the global sample. Table 1 provides
a list of participating countries, number of participants from each
allergy society, mean age of respondents, sex ratio, specialty,
professional experience, percent of professionals who spend more than 20
hours/week looking after patients suffering from A/H diseases, working
setting, information relating to coding practice in day-to-day clinical
work and a rating of the appropriateness of the classification system in
use. As shown in Figure 1 and Table 1, all WHO global regions were
represented in the survey. Response rates were lowest for AFRO (1.7%)
and highest for EURO (46.5%).
Allergists with long-time professional experience working in private
and/or public settings were the principal respondents to the survey and
97% of these reported seeing allergic patients regularly (Table 1);
71% of this group reported having more than 10 years of professional
experience in A/H and nearly two thirds (64.5%) spent more than 20
hours per week seeing A/H patients.
As shown in Table 1, 59% of the respondents use ICD-10 or national
adaptations thereof in their daily clinical work; 11.4%, mainly from
the AFRO region, use ICD-9 or its national adaptations. A high
proportion of respondents (72.2%) from the EMRO region do not use any
classification/ coding system. 56.9% of the respondents mentioned that
they were personally responsible for coding diseases/interventions in
their practice and 25.1% reported that a staff member of their practice
or institution perform this task.
From overall responses, the main utility of a classification and coding
system was judged to be the “basis for generating national health
statistics”, followed by “to support communication between
clinicians”. The responses differed according to the world regions
(Figure 2). For instance, most of participants from the SEARO region use
the classification for “communication with the payers” whereas ERMRO
representatives use it for “communication between clinicians and
patients”.
Although ICD-10 was shown to be the classification system most used
worldwide, 69.5% of users did not consider it appropriate for clinical
practice. The participants highlighted the need for inclusion of missing
allergic diseases (75.3%) and the presence of diseases with overlapping
classification (e.g., Asthma induced by Aspirin) (64%). In
response to these needs, the respondents were aware that ICD-11 will
allow more accurate representation of A/H (77.1%), will support
harmonization of terminology and definitions in the field of allergy
(56.9%) and will be able to support correct diagnosis and management
(49.5%) (Table 2).