Unpacking the Challenges: Clinical Coding of Intimate Partner Violence in England

In a fascinating and significant study, Olive (2023), published in the Journal of Medical Microbiology, uncovers several challenges related to clinical coding for intimate partner violence (IPV) in England, using the International Classification of Disease (ICD-10) system. By delving into population health data and administrative health data systems, the study investigates the applicability and effectiveness of ICD-10 codes for IPV.

Methodology: Exploring Trends and Perspectives

This research uses a mixed-method approach, providing a comprehensive view of the problem. Firstly, it analysed trends in the application of ICD-10 IPV codes for admissions to NHS hospitals in England over a five-year period. Secondly, it incorporated the perspective of clinical coders through focus group interviews, thereby adding rich qualitative insights to the quantitative data.

Results: Low Use and Conceptual Ambiguity

The results of the study indicate a generally low usage of ICD-10 IPV classifications across NHS Trusts in England. The research also unearthed considerable variation in the number of applications across different NHS providers, an inconsistency that could not be adequately explained by demographic differences or rates of violence perpetration.

Further, the interviews with clinical coders revealed a degree of conceptual ambiguity concerning IPV classifications. This ambiguity posed challenges for clinical coding, calling into question the reliability and validity of ICD-10’s IPV classifications.

Implications: Inability to Extract Robust Data

The study concludes that the current ICD-10 classifications do not allow for the extraction of robust data about populations exposed to IPV for purposes of audit, governance, or research. This situation has serious implications as it hampers the healthcare system’s ability to identify, understand, and address the issue of IPV adequately.

The Need for Improvement: Prioritising IPV in Health Information Systems

Olive’s (2023) study highlights the critical need for the development of ICD codes to more accurately capture IPV cases within health information systems. Without improved and precise clinical coding, IPV is unlikely to be afforded the necessary prioritisation and funding proportional to the health burden and service demands it poses.

This research serves as a potent reminder of the pivotal role clinical coding plays in healthcare. Effective clinical coding not only streamlines the administrative processes but also provides crucial data for monitoring population health trends, guiding healthcare policies, and informing clinical research.

Conclusion: Addressing the Challenges of IPV Clinical Coding

The challenges associated with the clinical coding of IPV in England, as highlighted by Olive’s study, underscore the importance of addressing this issue promptly. Accurate clinical coding can significantly contribute to identifying and managing IPV. It can provide robust data for healthcare research, guiding policies and interventions that can help tackle IPV more effectively. In the evolving landscape of healthcare, the role of clinical coding in capturing important health issues like IPV is more crucial than ever.


Olive, P. (2023). Intimate partner violence and clinical coding: issues with the use of the International Classification of Disease (ICD-10) in England. Journal of Medical Microbiology, 23(4). https://doi.org/10.1177/1355819618781413

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