Introduction of comprehensive coding of diagnoses in outpatient care in Switzerland : benefits and challenges

Wieser, Simon; Stucki, Michael; Kohler, Andreas; Lenzin, Golda; Schärer, Xavier

Publication type:	Conference poster
Type of review:	Not specified
Title:	Introduction of comprehensive coding of diagnoses in outpatient care in Switzerland : benefits and challenges
Authors:	Wieser, Simon Stucki, Michael Kohler, Andreas Lenzin, Golda Schärer, Xavier
et. al:	No
Conference details:	Swiss Public Health Conference, Lausanne, Schweiz, 12.-13. September 2023
Issue Date:	12-Sep-2023
Language:	English
Subject (DDC):	362.1041: Health economics
Abstract:	Background: The Swiss Health Insurance Act mandates the coding of diagnoses and treatments in outpatient care. While treatments are coded by tariff positions, a systematic coding of diagnoses is still lacking. It is also unclear which diagnostic classification should be applied. Consequently, there is a substantial lack of transparency regarding the diseases treated in outpatient care and the changes in their epidemiology. Method: We explored the potential benefits of diagnostic coding in outpatient care as well as the main challenges from the point of view of the various stakeholders. We defined the criteria for suitable diagnostic classifications and examined the strength and weaknesses of potential classifications. We conducted a literature review, evaluated current diagnostic coding by selected health care providers in claims data, and performed 27 stakeholder interviews with health professionals, health insurers, researchers and statistical and health authorities. The study was commissioned by the Federal Statistical Office. Results: To date, diagnoses are rarely and inconsistently recorded on outpatient care invoices in Switzerland. While different potential uses of diagnostic coding in claims data are known, there is no consensus on which purpose should be prioritized and who should own and process this data. A decision on the type of use is however required for the choice of a suitable type of diagnostic classification. In contrast to other countries, reimbursement of ambulatory care is currently not linked with diagnostic coding. For service providers the introduction of diagnostic coding would thus lead to additional administrative efforts without clear benefits. Conclusions: The type of utilization of diagnostic coding in outpatient care and its implementation should be developed in a participatory process with the stakeholders involved. For a successful introduction of a comprehensive and good quality diagnostic coding, its purpose and its implementation must be in line with the incentives of service providers.
URI:	https://digitalcollection.zhaw.ch/handle/11475/29686
Fulltext version:	Published version
License (according to publishing contract):	Licence according to publishing contract
Departement:	School of Management and Law
Organisational Unit:	Winterthur Institute of Health Economics (WIG)
Appears in collections:	Publikationen School of Management and Law

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Wieser, S., Stucki, M., Kohler, A., Lenzin, G., & Schärer, X. (2023, September 12). Introduction of comprehensive coding of diagnoses in outpatient care in Switzerland : benefits and challenges. Swiss Public Health Conference, Lausanne, Schweiz, 12.-13. September 2023.

Wieser, S. et al. (2023) ‘Introduction of comprehensive coding of diagnoses in outpatient care in Switzerland : benefits and challenges’, in Swiss Public Health Conference, Lausanne, Schweiz, 12.-13. September 2023.

S. Wieser, M. Stucki, A. Kohler, G. Lenzin, and X. Schärer, “Introduction of comprehensive coding of diagnoses in outpatient care in Switzerland : benefits and challenges,” in Swiss Public Health Conference, Lausanne, Schweiz, 12.-13. September 2023, Sep. 2023.

WIESER, Simon, Michael STUCKI, Andreas KOHLER, Golda LENZIN und Xavier SCHÄRER, 2023. Introduction of comprehensive coding of diagnoses in outpatient care in Switzerland : benefits and challenges. In: Swiss Public Health Conference, Lausanne, Schweiz, 12.-13. September 2023. Conference poster. 12 September 2023

Wieser, Simon, Michael Stucki, Andreas Kohler, Golda Lenzin, and Xavier Schärer. 2023. “Introduction of Comprehensive Coding of Diagnoses in Outpatient Care in Switzerland : Benefits and Challenges.” Conference poster. In Swiss Public Health Conference, Lausanne, Schweiz, 12.-13. September 2023.

Wieser, Simon, et al. “Introduction of Comprehensive Coding of Diagnoses in Outpatient Care in Switzerland : Benefits and Challenges.” Swiss Public Health Conference, Lausanne, Schweiz, 12.-13. September 2023, 2023.