Mortality 2003 Changes in Data Reporting and Analysis: The Transition from ICD-9 to ICD-10 The International Classification of Diseases is an internationally recognized system of collecting, processing, classifying, and presenting mortality statistics. In order to reflect advances in medicine, terminology, and disease classification, the classification system has been revised ten times since its inception in 1900. The 1999 implementation of ICD-10 (International Classification of Diseases, Tenth Revision) introduced significant changes to the classification system, such as the conversion from numeric to alphanumeric codes, the reclassification of certain conditions under new categories, the institution of new cause of death titles and codes, and new procedures for determining the underlying cause of death. In addition, ICD-10 has greater detail, with over 3,000 more categories than ICD-9. For example, when using ICD-10 coding and classification rules, fewer deaths are attributable to pneumonia. This is because pneumonia is more often considered a consequence of another cause, rather than the actual underlying cause of death, as it was under ICD-9 rules. This change in classification reduced the number of Influenza and Pneumonia deaths by 30% when comparing 1998 and 1999 national data. These changes have affected the manner in which mortality statistics are reported and analyzed, preventing direct comparison of ICD-9 (1979-1998) and ICD-10 (1999 and later) coded data. To address the comparability issue, the National Center for Health Statistics (NCHS) developed comparability ratios*, which, when applied to pre-1999 mortality data, are intended to correct for discrepancies due to the ICD conversion. Because these ratios were created using national data, which is not disaggregated by age, sex, or race, they may not accurately portray the effects of the coding changes, particularly for a small state like Delaware. As a result, we employed alternative methods of presenting mortality data until we obtained five years of ICD-10 coded data. As of this report, we are once again able to calculate five-year mortality rates using 1999-2003 data years. The 1999-2003 age-adjusted rates for selected causes of death for Delaware and its counties are presented in Table F-30. We will continue this presentation of five-year rolling rates in subsequent years, allowing users to once again monitor mortality trends. *For a more thorough explanation of comparability ratios and effects of the ICD conversion, please refer to the NCHS website at: http://www.cdc.gov/nchs/about/major/dvs/icd10des.htm Mortality Highlights Key Indicators Period Delaware AADR1 Heart Disease • Deaths per 100,000 population 1999-2003 252.9 Cancer • Deaths per 100,000 population 1999-2003 207.2 Stroke • Deaths per 100,000 population 1999-2003 51.2 Unintentional Injuries • Deaths per 100,000 population 1999-2003 36.0 Diabetes • Deaths per 100,000 population 1999-2003 25.9 Kidney Disease • Deaths per 100,000 population 1999-2003 14.3 HIV Infection/AIDS • Deaths per 100,000 population 1999-2003 8.8 1. Age-adjusted death rate per 100,000 using 2000 U.S. Standard Population. There were 7,067 deaths to Delaware residents in 2003 (See Table F-1). The three leading causes of death in Delaware for the period of 1999- 2003 continue to be Heart Disease, Cancer, and Stroke (See Table F-7). From 1999-2003, accidents were the number one cause of death for persons 1-44 years of age, and were responsible for 47% of all deaths for persons 1-24 years of age (See Table F-11). Life expectancy for babies born in 2003 varied by race-sex group: white males - 75.3, white females - 80.7, black males - 69.2, and black females - 75.8 (see Table F-27). Printed copies of the graph and charts can by obtained by contacting: Delaware Division of Public Health Delaware Health Statistics Center 417 Federal Street Dover, Delaware 19901 (302) 744-4541