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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Determinar el grado de exhaustividad y precisi&#243;n de los c&#243;digos CIE-9-MC asignados por los m&#233;dicos de primaria en sus historias cl&#237;nicas informatizadas&#59; evaluar el impacto de actividades para su mejora&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Los c&#243;digos de 87&#46;806 pacientes de 56 m&#233;dicos de Osakidetza&#47;Servicio Vasco de Salud fueron evaluados en 3 ocasiones en 1 a&#241;o&#44; seg&#250;n los siguientes criterios&#58; correspondencia con un c&#243;digo CIE-9-MC v&#225;lido&#59; concordancia entre diagn&#243;stico y c&#243;digo&#59; porcentaje de consultas sin diagn&#243;stico&#46; Finalmente&#44; se contrastaron&#44; con un registro previo de morbilidad atendida&#44; los promedios de diagn&#243;sticos &#250;nicos y tasas anuales de enfermedades de los 84&#46;136 pacientes que permanecieron con el mismo m&#233;dico al menos 6 meses&#46; Se realizaron 2 intervenciones para mejorar la codificaci&#243;n&#58; correcci&#243;n central de errores detectados&#59; asesoramiento e informaci&#243;n a los m&#233;dicos de sus resultados individuales&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">En la primera evaluaci&#243;n&#44; el 59&#37; de los diagn&#243;sticos no conten&#237;a ning&#250;n c&#243;digo CIE-9-MC asociado&#44; mientras que a la finalizaci&#243;n este porcentaje descendi&#243; al 2&#37;&#46; El porcentaje de errores &#40;discrepancia entre diagn&#243;stico del episodio y c&#243;digo CIE9-MC&#41; disminuy&#243; del 17 al 3&#37;&#46; El promedio anual de diagn&#243;sticos por paciente fue ligeramente menor que en el archivo de referencia &#40;2&#44;26 frente a 2&#44;43&#41;&#44; as&#237; como las tasas de diversos grupos de enfermedades&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Es factible que los m&#233;dicos de atenci&#243;n primaria alcancen un alto grado de calidad en la clasificaci&#243;n de diagn&#243;sticos mediante CIE-9-MC&#46; La implantaci&#243;n de medidas de evaluaci&#243;n&#44; correcci&#243;n de errores e informaci&#243;n a los cl&#237;nicos permiti&#243; mejorar notablemente los resultados iniciales&#46;</p>"
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p class="elsevierStyleSimplePara elsevierViewall">To determine the completeness and accuracy of ICD-9-CM codes allocated by primary health care physicians in their computerized medical records and evaluate the effects of improvement procedures&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">The codes of 87&#44;806 patients assigned to 56 primary care physicians in the Basque National Health Service in Spain&#44; were evaluated 3 times over a 1-year period according to the following criteria&#58; correspondence to a valid ICD- 9-CM code&#44; agreement between diagnosis and code&#44; and the percentage of visits with an unspecified reason for consultation&#46; Finally&#44; the mean number of unique diagnoses and rates of diagnostic groups in the 84&#44;136 patients that remained with the same physician for a minimum of 6 months were contrasted with another previously registered morbidity database&#46; Two interventions were performed to improve coding&#58; detected errors were corrected centrally and physicians were assessed and given information on their individual results&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Diagnoses lacking an ICD-9-DIC code decreased from 59&#37; in the first assessment to 2&#37; at the end of the study period&#46; The percentage of coding mistakes &#40;discrepancies in episode diagnosis and ICD-9-CM code&#41; decreased from 17&#37; to 3&#37;&#46; The mean annual number of diagnoses per patient was slightly lower than that in the reference database &#40;2&#46;26 versus 2&#46;43&#41;&#46; The same result was observed in the rates of some diagnostic groups&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Primary care doctors can achieve a high degree of quality in ICD-9-CM diagnosis coding&#46; Implementing procedures for evaluating coding&#44; rectifying mistakes&#44; and providing information to physicians markedly improved the initial results&#46;</p>"
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