BRIEF REPORT
John S. Maier, PhD, MD; Derek Baughman, MD; Chris Schiemeyer; Kevin Kindler, MD
Corresponding Author: John S. Maier, PhD, MD; University of Pittsburgh
Email: jsmaier@pitt.edu
DOI: 10.3122/jabfm.2024.240254R1
Keywords: Administration, Benchmarking, Comprehensive Health Care, Family Medicine, Health Care Surveys, Linear Regression, National Ambulatory Medical Care Survey, Primary Health Care
Dates: Submitted: 07-01-2024; Revised: 01-23-2025; Accepted: 01-29-2025
Status: In production for ahead of print.
BACKGROUND: Comprehensiveness in primary care is defined as the breadth of services provided by a healthcare provider team and is an important metric related to patient outcomes and care delivery. We describe a novel measure of comprehensiveness based on ICD-10 codes.
METHODS: We compare the distribution of ICD-10 codes from the care of a large population at a regional academic health system to the distribution of codes from the National Ambulatory Medical Care Survey (NAMCS) using linear regression and the mathematical inner product.
RESULTS: The linear regression between the pattern of ICD-10 codes for the selected population and the NAMCS has a slope 1.00, 95% CI 0.57:1.43, p =0.0002, R^2 0.62. When considering specific specialty areas of practice, primary care is distinct from specialty care based on the inner product between the distribution of care for a given specialty independent of whether a regional or national reference population is used.
CONCLUSION: The distribution of care based on ICD-10 codes provides a stable and possibly generalizable reference for comprehensive care. The inner product of an ICD-10 care distribution and a reference provides a quantitative estimate of comprehensiveness that distinguishes primary care from specialty care.