Keywords: Long Covid, Primary Health Care, Coding System, Europe, Health Information Systems
Introduction:
Standardized coding systems are crucial for accurate diagnoses, continuity of care, and reliable data analysis in primary healthcare (PHC). The COVID-19 pandemic, and particularly the emergence of Long COVID, has highlighted the need for coding systems capable of addressing its complexities. This study evaluates the use of coding systems in PHC across Europe, examining their interoperability with secondary care (SC) and their effectiveness in documenting Long COVID-related conditions, with implications for quality and patient safety.
Method:
A cross-sectional study was conducted across 35 European countries to assess the use of coding systems in both PHC and SC, including ICPC-2, ICD-9, and ICD-10. The analysis focused on coding Long COVID-related conditions and the interoperability between PHC and SC systems. Descriptive statistics were employed to identify gaps and opportunities for improvement.
Results:
Survey responses were received from 30 countries. ICPC-2 was used in PHC in only one country, ICD-9 in four, and ICD-10 in twelve, while eleven countries reported the absence of any coding system in PHC. ICD-10 was used in SC in 19 countries, with 12 using the same coding system for both PHC and SC. The limited integration of ICD-10 into PHC hinders effective care coordination. Furthermore, most countries lack mechanisms to link Long COVID-related conditions (e.g., lung fibrosis, autoimmune diseases) under a unified diagnosis code in PHC, leading to fragmented coding. This gap complicates the tracking and management of Long COVID within PHC settings.
Conclusions:
The findings highlight the need to harmonize coding systems across Europe, advocating for the better integration of ICPC-2 and ICD-10 into PHC and SC. Countries without a coding system in PHC should prioritize implementation. Enhancing standardization and interoperability is vital for improving care quality, patient safety, and data reliability, particularly in managing complex conditions such as Long COVID.
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