A mixed method qualitative study to develop ICPC-2-SL: Dynamic, optimized and scalable version of the international classification of primary care for Sri Lanka

Abstract

INTRODUCTION & OBJECTIVES: There is a paucity of current, reliable published information regarding primary care morbidity in Sri Lanka. Classification and Coding Systems (CCS) can improve the quality of recorded data through electronic Health Information systems (e-HIS). International Classification of Primary Care (ICPC-2) was specifically designed for primary care. A study was conducted to develop an optimized, dynamic, scalable and implementable version of ICPC-2 (ICPC-2-SL) for Sri Lanka. METHODS: A systematized review of literature (SRI.) done to ascertain factors affecting the implementation of CCS. A qualitative study (QS) was conducted (in-depth interviews) to yield perceived factors affecting implementation and to develop a framework. The ICPC-2-SL version 1.0 was developed by an optimization process (OP) using pooling and coding of the reason for encounters, problem definitions and also by amalgamating codes developed by a previous study in Sri Lanka. New set of codes developed for dental primary care encounters. Final code-set was reviewed, agreed upon using nominal panel technique. RESULTS: SRL informed that perceived benefit of data recording, burden, time constraints, training received, and existing knowledge affects the implementation success. The QS resulted the national level CCS implementation framework. The OP resulted in 103 country specific, 4th digit ICPC-2 codes and 37 new codes for dental primary care to develop the version1.0 of the ICPC-2-SL. CONCLUSION: The implementation framework developed can be validated and used to plan, carry out and monitor implementation activities. The ICPC-2-SL version 1.0 could be adopted and scaled-up after a proper demonstration project. The comprehensive set of dental care codes could be a valuable extension to the ICPC-2 in global context.