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).