Introduction to the Coding Framework and Usage Process of the International Classification of Primary Care, 3rd Edition (ICPC-3)

doi:10.12114/j.issn.1007-9572.2025.0249

Abstract

Abstract:

Against the backdrop of accelerated global population aging and the escalating burden of chronic disease multimorbidity, primary care faces three core challenges: fragmented health data, inefficient coordination between medical treatment and prevention, and suboptimal resource allocation. The International Classification of Primary Care, 3rd Edition (ICPC-3) released by the World Organization of Family Doctors (WONCA) in December 2020, maintained its strengths in systematically classifying and encoding reasons for encounter (RFE), health problems, and processes of care. It expanded upon previous versions by adding chapters on functioning-related concepts and refining classifications within an enhanced coding framework. Compared with other disease classification systems, ICPC-3 placed greater emphasis on patient-centeredness. It comprehensively encompassed complex symptoms, undifferentiated conditions, and non-disease states encountered in primary health care, thereby accentuating the value of ICPC-3. The unique dual-axis framework of ICPC-3 enhanced its systematicity and logical coherence, allowing it to complement other disease classification methodologies. Consequently, it achieved widespread global adoption. The present paper systematically introduced the coding framework and operational procedures of ICPC-3, aiming to facilitate its implementation and dissemination within China.

Key words: ICPC-3, Disease classification, International Classification of Diseases, Coding framework, Usage process, General practice

摘要： 在全球老龄化加速、慢性病共病负担激增的背景下，全科医疗面临健康数据碎片化、医防协同低效、资源错配三大核心挑战。世界家庭医生组织（WONCA）2020年12月发布的《国际初级卫生保健分类第3版》（ICPC-3）延续了对就诊原因、健康问题和诊疗流程进行系统性分类编码的优势，增加了功能相关等章节，并重新分类和提供编码框架。相比于其他疾病分类系统，ICPC-3更加注重以患者为中心，囊括初级卫生保健/基层医疗卫生工作中面临的复杂症状、未分化疾病和非疾病状况，突出了基层医疗的服务价值。ICPC-3特有的双轴分类法提升了其系统性和合理性，可与其他疾病分类方法互补，因而在世界范围内广泛使用。本文系统介绍了ICPC-3的编码框架和使用流程，以期为ICPC-3在我国推广应用提供参考。

关键词: 国际初级卫生保健分类第3版, 疾病分类, 国际疾病分类法, 编码框架, 使用流程, 全科医学

JIANG Yue,LI Jie,GU Yuan. Introduction to the Coding Framework and Usage Process of the International Classification of Primary Care, 3rd Edition (ICPC-3)[J]. Chinese General Practice, 2025, 28(29): 0-c5. DOI: 10.12114/j.issn.1007-9572.2025.0249.
姜岳,李杰,顾湲. 《国际初级卫生保健分类第3版》编码框架与使用流程简介[J]. 中国全科医学, 2025, 28(29): 0-c5. DOI: 10.12114/j.issn.1007-9572.2025.0249.

Figures/Tables 5

References 10

[1]	An international classification of health problems of primary care[J]. Am Fam Physician，1979,19(2):95.
[2]	路孝琴，梁万年，贾庆春，等. 基层医疗国际分类（ICPC）及其在全科家庭医疗中的应用[J]. 中国全科医学，2003,6(1):86-88. DOI：10.3969/j.issn.1007-9572.2003.01.049.
[3]	LAMBERTS H, WOOD M. International Classification of Primary Care[M]. Oxford：Oxford University Press，1987.
[4]	NAPEL H T, VAN BOVEN K, OLAGUNDOYE O A，et al. Improving primary health care data with ICPC-3：from a medical to a person-centered perspective[J]. Ann Fam Med，2022,20(4):358-361. DOI：10.1370/afm.2830.
[5]	WOOD M, LAMBERTS H, MEIJER J S，et al. The conversion between ICPC and ICD-10. Requirements for a family of classification systems in the next decade[J]. Fam Pract，1992,9(3):340-348. DOI：10.1093/fampra/9.3.340.
[6]	TOMANDL J, BOOK S, GOTTHARDT S，et al. Laying the foundation for a core set of the International Classification of Functioning，Disability and Health for community-dwelling adults aged 75 years and above in general practice：a study protocol[J]. BMJ Open，2018,8(8):e024274. DOI：10.1136/bmjopen-2018-024274.
[7]	HENDERSON T, SHEPHEARD J, SUNDARARAJAN V. Quality of diagnosis and procedure coding in ICD-10 administrative data[J]. Med Care，2006,44(11):1011-1019. DOI：10.1097/01.mlr.0000228018.48783.34.
[8]	LEONARDI M, LEE H, KOSTANJSEK N，et al. 20 years of ICF-international classification of functioning，disability and health：uses and applications around the world[J]. Int J Environ Res Public Health，2022,19(18):11321. DOI：10.3390/ijerph191811321.
[9]	The ICPC-3 Foundation. International Classification of Primary Care-3rd Revision（2023）[EB/OL]. [2025-07-22].
[10]	WONCA, BOVEN K V, NAPEL H T，et al. ICPC-3 International Classification of Primary Care: User Manual and Classification[M]. 3rd ed. Boca Raton：CRC Press，2022.

患者表述	适用章节	示例代码
身体系统相关的症状/主诉	器官章节（B-W）或A章S子组件	胸痛编码为AS12/KS01/RS01（据患者描述定位）
自我诊断的疾病	器官章节的D子组件	"我可能有糖尿病"编码为TD71（需结合确诊结果调整）
疫苗接种/筛查请求	A1章	风疹疫苗编码为A202
活动受限	Ⅱ章（2F01-2F69）	无法爬楼梯编码为2F28+PSV.3
社会问题	Z章	失业编码为ZC17
干预请求（开药/检查）	Ⅰ章	尿检编码为U106（明确原因）

患者表述	适用章节	示例代码
身体系统相关的症状/主诉	器官章节（B-W）或A章S子组件	胸痛编码为AS12/KS01/RS01（据患者描述定位）
自我诊断的疾病	器官章节的D子组件	"我可能有糖尿病"编码为TD71（需结合确诊结果调整）
疫苗接种/筛查请求	A1章	风疹疫苗编码为A202
活动受限	Ⅱ章（2F01-2F69）	无法爬楼梯编码为2F28+PSV.3
社会问题	Z章	失业编码为ZC17
干预请求（开药/检查）	Ⅰ章	尿检编码为U106（明确原因）

类别	代码范围	应用场景
活动或参与限制	2F01~2F69	"因痔疮不能久坐"编码为2F58+PSV.3
身体功能损伤	2F71~2F99	"间歇性头晕"编码为2F83+PSV.1
环境因素	2R01~2R29	"住房无卫生间"编码为2R04+FBV.6

类别	代码范围	应用场景
活动或参与限制	2F01~2F69	"因痔疮不能久坐"编码为2F58+PSV.3
身体功能损伤	2F71~2F99	"间歇性头晕"编码为2F83+PSV.1
环境因素	2R01~2R29	"住房无卫生间"编码为2R04+FBV.6

类型	子组件	示例与代码
诊断性操作	—1xx	血压测量编码为K102
治疗/预防操作	—2xx	拆石膏编码为L207.2
护理计划项目	—3xx	糖尿病管理编码为T308
转诊咨询	—5xx	转诊专科编码为—506.2心脏病专家
行政操作（唯一活动时）	—6xx	填写保险表编码为A601