A Reasonfor Visit Classification for AmbulatoryCare

DATA EVALUATION AND METHODS RESEARCH

Series 2 Number 78

A Reasonfor Visit Classification for AmbulatorCy are

This report presents a classification system developed to code rea-

sons for seeking ambulatory medical care.

.

DHEW Publication No. (PHS) 79-1352

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

Public Health Service

Office of the Assistant Secretary for Health

National Center for Health Statistics

Hyattsville, Md.

February 1979

Library of Congress Cataloging in Publication Data

Schneider, Don. A reason for visit classification for ambulatory care.

(Vital and health statistics: Series 2, Data evaluation and methods research; no. 78)

(DHEW publication; no. (PHS) 79-1352)

Includes bibliographical references and index.

1. Nosology. 2. Ambulatory medical care. I. Appleton, Linda, joint author. II. McLemore,

Thomas, ,joint author. III. Title. IV. Series: United States. National Center for Health Sta-

tistics. Vital and health statistics: Series 2, Data evaluation and methods research; no. 78.

V. Series: United States. Dept. of Health, Education and Welfare. DHEW publication;

no. (PHS) 79-1352. [DNLM: 1. Ambulatory care. 2. Classification. W2 A N148vb no. 78]

RA409.U45 no. 78

[RB115]

312'.07'23s

[616'.001'2]

78-11549

NATIONAL CENTER FOR HEALTH STATISTICS

DOROTHY P. RICE, Director

ROBERT A. ISRAEL, Deputy Director JACOB J. FELDMAN, Ph.D., Associate Director for Analysis GAIL F. FISHER, Ph.D., Associate Director for the Cooperative Health Statistics System

ELIJAH L. WHITE, Associate Director for Data Systems JAMES T. BAIRD, JR., Ph.D., Associate .Directorfor International Statistics

ROBERT C, HUBER, Associate Director for Management MONROE G. SIRKEN, Ph. D., Associate Director for Mathematiccd Statistics

PETER L. HURLEY, Associate Director for Operations JAMES M. ROBEY, Ph.D., Associate Director for Program Development

PAUL E. LEAVERTON, Ph. D., Associate Director for Research ALICE HAYWOOD, Information Officer

DIVISION OF HEALTH RESOURCES UTILIZATION STATISTICS

SIEGFRIED A. HOERMANN, Director JOAN F. VAN NOSTRAND, Chiefi Long-Term Care Statistics Branch SIEGFRIED A. HOERMANN, Acting C)ziej Hospital Care Statistics Branch

STEWART C. RICE, Chief Family Pknning Statistics Branch JAMES E. DeLOZIER, Chief Ambukztory Care Statistics Branch MANOOCHEHR K. NOZARY, Chief Technical Services Branch

Vital and Health Statistics-Series 2-No. 78

DHEW Publication No. (PHS) 79-1352

Library of Congress Catalog Card No. 78-11549

PREFACE

This report presents a Reason for Visit Classification for Ambulatory Care. The Reason for Visit Classification (RVC), developed by The American Medical Records Association under the auspices of the National Center for Health Statistics (NCHS) for use in the National Ambulatory Medical Care Survey and by others, is primarily a classification of patient or lay terminology encountered in the ambulatory care setting. The emphasis of the RVC is on the patient's motivation for seeking medical care and his perspective of the probIem or reason for visit. This is an important conceptual difference distinguishing the RVC from the Ninth Revision of the International Classification of Diseases (ICD-9) and its U.S. adaptation, International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The ICD-9 is an official World Health Organization (WHO) publication and will be used in the United States for mortality coding beginning in 1979. The ICD-9-CM has been prepared jointly by the Government and private sector and has resulted in an expanded, but compatible, version of the ICD-9 which is used in the United States to classify diseases and conditions in clinical settings.

The WHO Center for Classification of Diseases for North America at the NCHS is responsible for the ICD in the United States and for the official U.S. and Canadian input into future revisions of the ICD. The WHO reco~izes that the ICD-9 does not entirely meet the needs of an ambulatory care classification. It is hoped that the experience gained through the use of the RVC will provide an important contribution to future revisions of the ICD.

It is the policy of NCHS that methodological reports are to be given peer review for technicaI merit and readability y by one or more persons familiax with the subject matter of the report, but not invoIved in producing the report. Ms. Alice Hetzel of the Division of Vital Statistics performed the peer review for this report.

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ACKNOWLEDGMENT

The classification presented in this report is based primarily on the work of the American Medical Records Association (AMRA) under contract number HRA 230-75-0197 with the National Center for Health Statistics. The contribution of the AMRA and its staff is ,gratefully acknowledged.

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