Background
Methods
Data Source and Subjects
ICPC codes | Disease entity | Reasons for exclusion | number | % |
---|---|---|---|---|
K87 | Complicated hypertension | The presence of unknown complications may favor or preclude prescription of a particular drug class | 3310 | 5.8% |
T90 | Diabetes Mellitus | Favors the choice of ACEIs | 15560 | 27.3% |
T901 | Impaired glucose tolerance | 353 | 0.6% | |
T92 | Gout | Contraindication of thiazide diuretics | 635 | 1.1% |
T93 | Lipid disorders | Favor the exclusion of thiazide diuretics and β-blockers | 1186 | 2.1% |
K90 | Stroke/cerebrovascular accident | Favor the choice of β-blockers | 1920 | 3.4% |
K91 | Cerebrovascular disease | 130 | 0.2% | |
K74 | Ischemic Heart Disease with angina | 348 | 0.6% | |
K76 | Ischemic Heart Disease without angina | 1099 | 1.9% | |
K75 | Acute Myocardial Infarction | 213 | 0.4% | |
K77 | Heart Failure | Favor the choice of ACEIs | 794 | 1.4% |
K84 | Heart Disease, other | Favor the choice of β-blockers or ACEIs | 168 | 0.3% |
K99 | Cardiovascular disease, other | 113 | 0.2% | |
R79 | Chronic Bronchitis | Contraindication of β-blockers | 436 | 0.8% |
R95 | Chronic Obstructive Pulmonary Disease | 2199 | 3.9% | |
R96 | Asthma | 1083 | 1.9% | |
U14 | Kidney symptoms/complaints | Either favor or a contraindication of ACEIs | 312 | 0.5% |
U88 | Glomerulonephritis/nephrosis | 36 | 0.1% | |
Y85 | Benign Prostatic Hypertrophy | Favor the prescription of α-blockers | 2917 | 5.1% |
U78 | Benign Neoplasm Urinary Tract | 30 | 0.1% | |
Y79 | Benign/unspecified neoplasm, male genital | 1 | 0.0% |
Variables and Statistical Analysis
Results
Overall patient breakdown
Distribution of codes and morbidities
Comparing patient characteristics among different coding groups
Coding | K86 coded & without exclusion codes (n = 30,704) | K86 coded with exclusion codes (n = 16,155) | No K86 but with exclusion codes (n = 10,182) | No K86 & no exclusion codes (36,409) | All cases (n = 93,450) | p value* |
---|---|---|---|---|---|---|
Patient
|
"K86 only group"
|
"combined group"
|
"Exclusion group"
|
"Non-coded group"
| ||
Age on appt. (no.%)
| ||||||
<50 | 4550(14.8) | 1,073 (6.6) | 791 (7.8) | 7,484 (20.6) | 13898(14.9) | <0.001 |
50–59 | 8116(26.4) | 2,814 (17.4) | 1,804 (17.7) | 9,704 (26.7) | 22438(24.0) | |
60–69 | 6954(22.6) | 4,191(25.9) | 2,421 (23.8) | 7,516 (20.6) | 21082(22.6) | |
≥70 | 11084(36.1) | 8,077 (50.0) | 5,166 (50.7) | 11,705 (32.1) | 36032(38.6) | |
Mean Age on appt . (SD) (95% C.I.) | 63.87(13.06) | 68.22 (11.61) | 68.45 (12.46) | 61.77 (14.26) | 64.30 (13.51) | <0.001 |
(63.73, 64.02) | (68.04, 68.40) | (68.21, 68.69) | (61.62, 61.91) | (64.21, 64.39) | ||
Gender(No./%) | ||||||
Male
| 11,323 (36.9) | 7,442 (46.1) | 6,153 (60.4) | 15,412 (42.3) | 40330 (43.2) | <0.001 |
Female
| 19,381 (63.1) | 8,713 (53.9) | 4,029 (39.6) | 20,997 (57.7) | 53120 (56.8) | |
Payment status
| ||||||
Fee-waivers | 7,949 (25.9) | 4,379 (27.1) | 3,147 (30.9) | 9,696 (26.6) | 25,171 (26.9) | <0.001 |
Non- waivers | 22,755 (74.1) | 11,776 (72.9) | 7,035 (69.1) | 26,713 (73.4) | 68,279 (73.1) | |
District of residence
| ||||||
Shatin | 18,510 (60.3) | 8,817 (54.6) | 5,524 (54.3) | 12,120 (33.3) | 44,971 (48.1) | <0.001 |
Taipo | 6,780 (22.1) | 2,883 (17.8) | 1,773 (17.4) | 11,156 (30.6) | 22,592 (24.2) | |
North | 4,068 (13.2) | 3,721 (23.0) | 2,206 (21.7) | 10,684 (29.3) | 20,679 (22.1) | |
Others | 1,346 (4.4) | 734 (4.5) | 679 (6.7) | 2,449 (6.7) | 5,208 (5.6) | |
Service type
| ||||||
General | 28,946 (94.3) | 13,881 (85.9) | 7,523 (73.9) | 34,524 (94.8) | 84,874 (90.8) | <0.001 |
FMSC/IC | 1,625 (5.3) | 2,260 (14.0) | 2,618 (25.7) | 1,673 (4.6) | 8,176 (8.7) | |
Staff clinic | 133 (0.4) | 14 (0.1) | 41 (0.4) | 212 (0.6) | 400 (0.4) | |
Appointment type (no./%)
| ||||||
New case | 14,705 (47.9) | 5,485 (34.0) | 4,784 (47.0) | 23,831 (65.5) | 48,805 (52.2) | <0.001 |
Old case | 15,999 (52.1) | 10,670 (66.0) | 5,398 (53.0) | 12,578 (34.5) | 44,645 (47.8) |
Factors associated with disease coding
Coding | Coded* (n = 57,041) | Non-coded(n = 36,409) | Adjusted Odds Ratios** (95% C.I.) | p value |
---|---|---|---|---|
Patient | ||||
Age on appt. (no.%)
| ||||
<50 | 6,414(11.2) | 7,484(20.6) | 1.000 (reference) | |
50–59 | 12,735(22.3) | 9,704(26.7) | 1.364(1.302, 1.429) | <0.001 |
60–69 | 13,566(23.8) | 7,516(20.6) | 1.774(1.692, 1.861) | <0.001 |
≥70 | 24,327(42.6) | 11,705(32.1) | 2.180(2.088, 2.277) | <0.001 |
Gender
| ||||
Male
| 24,918(43.7) | 15,412(42.3) | 1.000 (reference) | |
Female
| 32,123(56.3) | 20,997(57.7) | 1.202(1.168,1.238) | <0.001 |
Payment status
| ||||
Fee-waivers | 15,475(27.1) | 9,696(26.6) | ||
Payers | 41,566(72.9) | 26,713(73.4) | Not significant | |
District of residence
| ||||
Shatin | 32,851(57.6) | 12,120(33.3) | 1.000 (reference) | |
Taipo | 11,436(20.0) | 11,156(30.6) | 0.316(0.304, 0.327) | <0.001 |
North | 9,995(17.5) | 10,684(29.3) | 0.330(0.318, 0.343) | <0.001 |
Others | 2,759(4.8) | 2,449(6.7) | 0.405(0.381, 0.432) | <0.001 |
Service type
| ||||
General | 50,350(88.3) | 34,524(94.8) | 1.000 (reference) | |
FMSC | 6,503(11.4) | 1,673(4.6) | 1.448(1.362, 1.539) | <0.001 |
Staff clinic | 188(0.3) | 212(0.6) | 0.940(0.760, 1.162) | 0.565 |
Appointment type (no./%)
| ||||
New case | 24,974(43.8) | 23,831(65.5) | 1.000 (reference) | |
Old case | 32,067(56.2) | 12,578(34.5) | 2.394(2.324, 2.467) | <0.001 |