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What is the International Classification of Primary Care? Biaxial, alphanumeric classification of primary care problems and related actions 17 chapters [A-Z]: body systems Components in each chapter: symptoms and complaints

  1. What is the International Classification of Primary Care?  Biaxial, alphanumeric classification of primary care problems and related actions  17 chapters [A-Z]: body systems  Components in each chapter:  symptoms and complaints [01-29]  diagnostic / screening / preventive services [30-49]  medication / treatment / procedures [50-59]  test results [60,61]  administrative [62]  referrals, other reasons for encounter [63-69]  specific diagnoses [70-99]  Organized into episodes of care

  2. ICPC  Produced by the WONCA International Classification Committee (WONCA = World Organization of Family Physicians)  first published 1987 by Oxford University Press; second revision was published in 1998  2 nd revision was accepted within the World Health Organization Family of International Classifications  3rd Revision in Development

  3. key features of ICPC  Incorporates patient “voice” in Reason for encounter (RFE)  Symptom diagnoses where appropriate  Accommodates social problems (chapter Z)  Episode-based - can track process of care for problem over time  Limited granularity of basic code set – based upon prevalence of diagnosis  NOT A TERMINOLOGY - mapped to standard terminologies, classifications

  4. Maps and windows for ICPC  ICPC-2-R to ICD-10  ICPC-2-R to ICD-9-CM  ICPC-2 to SNOMED-CT primary care reference termset (refset) created by the IHTSDO GP/FP working group  windows from ICPC to:  CPT, SF-12, WONCA/COOP charts  work on ATC-codes, ICF

  5. Transhis

  6. RFE shortness of breath in 25-44 yo N=973 episodes . ICPC Final Diagnosis Prevalence OR (post prob) R78 Acute bronchitis 27.8% 20.03 R02 Shortness of breath 12.7% R98 hyperventilation 11.7% 24.47 R96 Asthma 10.4% 57.09 R74 URI 8.6% 1.84 R75 Sinusitis 2.9% 0.82 R96 Pneumonia 2.8% 13.16 Source: EFP / Dutch Transition Project database

  7. RFE shortness of breath in 65-74 yo N=788 episodes. ICPC Final Diagnosis Prevalence OR (post prob) R78 Acute bronchitis 30.4% 7.25 R02 Shortness of breath 14.6% K77 Heart failure 10.5% 15.13 R Emphysema/COPD 4.8% 21.14 R98 Hyperventilation 4.8% 12.92 R81 Pneumonia 4.3% 5.21 R96 Asthma 3.5% 4.0 Source: EFP / Dutch Transition Project database

  8. Comorbid conditions in men 45-64 (n=613) and men 65-74 (n=547) with diabetes Diagnosis % 45-64 % 65-74 Hypertension 22.8% 28.8% Hyperlipidemia 13.2% 10.8% Ischemic heart disease 8.0% 14.1% Low back pain 8.0% 4.6% Sleep problems 5.2% 6.8% Depressive disorder 3.9% 4.6% ED/impotence 3.4% 1.8% Heart failure - 7.1% Source: EFP / Dutch Transition Project database

  9. Primary Care Data Model Annals of Family Medicine, 2015 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4508165/

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