{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T18:23:54Z","timestamp":1774376634801,"version":"3.50.1"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National High Level Hospital Clinical Research Funding","award":["2022-PUMCH-B-091"],"award-info":[{"award-number":["2022-PUMCH-B-091"]}]},{"name":"National High Level Hospital Clinical Research Funding","award":["2022-PUMCH-A-223"],"award-info":[{"award-number":["2022-PUMCH-A-223"]}]},{"DOI":"10.13039\/501100018684","name":"National Health Commission of the People\u2019s Republic of China","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100018684","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The aim of this study was to disseminate insights from a nationwide pilot of the International Classification of Diseases-11th revision (ICD-11).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and methods<\/jats:title>\n                  <jats:p>The strategies and methodologies employed to implement the ICD-11 morbidity coding in 59 hospitals in China are described. The key considerations for the ICD-11 implementation were summarized based on feedback obtained from the pilot hospitals. Coding accuracy and Krippendorff\u2019s alpha reliability were computed based on the coding results in the ICD-11 exam.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the 59 pilot hospitals, 58 integrated ICD-11 Coding Software into their health information management systems and 56 implemented the ICD-11 in morbidity coding, resulting in 3\u00a0723\u00a0959 diagnoses for 873\u00a0425 patients being coded over a 2-month pilot coding phase. The key considerations in the transition to the ICD-11 in morbidity coding encompassed the enrichment of ICD-11 content, refinement of tools, provision of systematic and tailored training, improvement of clinical documentation, promotion of downstream data utilization, and the establishment of a national process and mechanism for implementation. The overall coding accuracy was 82.9% when considering the entire coding field (including postcoordination) and 92.2% when only one stem code was considered. Krippendorff\u2019s alpha was 0.792 (95% CI, 0.788-0.796) and 0.799 (95% CI, 0.795-0.803) with and without consideration of the code sequence, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This nationwide pilot study has enhanced national technical readiness for the ICD-11 implementation in morbidity, elucidating key factors warranting careful consideration in future endeavors. The good accuracy and intercoder reliability of the ICD-11 coding achieved following a brief training program underscore the potential for the ICD-11 to reduce training costs and provide high-quality health data. Experiences and lessons learned from this study have contributed to WHO\u2019s work on the ICD-11 and can inform other countries when formulating their transition plan.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocae031","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T20:43:42Z","timestamp":1709325822000},"page":"1084-1092","source":"Crossref","is-referenced-by-count":20,"title":["Methodologies and key considerations for implementing the International Classification of Diseases-11th revision morbidity coding: insights from a national pilot study in China"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1112-9822","authenticated-orcid":false,"given":"Meng","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing 100730, China"},{"name":"Collaborating Center for the WHO Family of International Classifications in China , Beijing 100730, China"},{"name":"National Center for Quality Control of Medical Records , Beijing 100730, China"}]},{"given":"Yipeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Collaborating Center for the WHO Family of International Classifications in China , Beijing 100730, China"},{"name":"Department of Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing 100730, China"}]},{"given":"Robert","family":"Jakob","sequence":"additional","affiliation":[{"name":"World Health Organization , Geneva 1211, Switzerland"}]},{"given":"Shanna","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing 100730, China"},{"name":"Collaborating Center for the WHO Family of International Classifications in China , Beijing 100730, China"},{"name":"National Center for Quality Control of Medical Records , Beijing 100730, China"}]},{"given":"Xue","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing 100730, China"},{"name":"Collaborating Center for the WHO Family of International Classifications in China , Beijing 100730, China"},{"name":"National Center for Quality Control of Medical Records , Beijing 100730, China"}]},{"given":"Xiaotong","family":"Jing","sequence":"additional","affiliation":[{"name":"Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing 100730, China"},{"name":"Collaborating Center for the WHO Family of International Classifications in China , Beijing 100730, China"},{"name":"National Center for Quality Control of Medical Records , Beijing 100730, China"}]},{"given":"Xin","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing 100730, China"},{"name":"Collaborating Center for the WHO Family of International Classifications in China , Beijing 100730, China"},{"name":"National Center for Quality Control of Medical Records , Beijing 100730, China"}]},{"given":"Aimin","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing 100730, China"},{"name":"Collaborating Center for the WHO Family of International Classifications in China , Beijing 100730, China"},{"name":"National Center for Quality Control of Medical Records , Beijing 100730, China"}]},{"given":"Naishi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing 100730, China"},{"name":"Collaborating Center for the WHO Family of International Classifications in China , Beijing 100730, China"},{"name":"Department of Endocrinology, Key Laboratory of Endocrinology of National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing 100730, China"}]},{"given":"Yi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing 100730, China"},{"name":"Collaborating Center for the WHO Family of International Classifications in China , Beijing 100730, China"},{"name":"National Center for Quality 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