Injury Data Introduction Intermediate Injury Prevention August 23-26, 2011 – Billings, MT.

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Presentation transcript:

Injury Data Introduction Intermediate Injury Prevention August 23-26, 2011 – Billings, MT

Injury Data Introduction Session Goal: Review injury data concepts fr: Intro to IP Course Understand classification system for injury morbidity & mortality Session Objectives: Describe the uses of data Define types of data Identify common sources of injury data Describe classification system for injury coding Interpret listings of injury morbidity/mortality codes

In Review… What are the two types of data? (hint: words v. numbers) How are data used in IP? What are the sources of injury data?

Two Types of Data Qualitative Data Interviews Surveys Focus groups Gives insight on development of your program/messages/ materials Quantitative Data Raw numbers Counts Identify injury patterns Surveillance Observations Risk assessments

Use of Data in Injury Prevention Understand trends patterns Risk factors Causes of injury in a population Set priorities for prevention Guide/persuade decision makers Develop a program messaging & materials (design of float coats in AK; safety message for a targeted group) Justify needs/build your case for funding (i.e., grants) Evaluate your program

Common sources of injury data? Local IHS severe injury surveillance system Resources and patient management system Medical records & death certificates EMS & police Questionnaires Surveys Focus groups Key information interviews Observations (seat belt surveys, home safety assessments)

In Review… What are the agents of injury? (hint: Injury results from the transfer of energy) What are the two main categories of injury? (hint: MVC and Domestic Violence are examples)

Agents of Injury Mechanical: crushing injury in wringer washer, energy transferred during MV crash Thermal: heat injuries – fire, hot water scalding Chemical: battery acid spills, poisoning Electrical: lightening Radiation: sunburn, overexposure to x-ray Absence of oxygen: drowning, suffocation, smoke inhalation, Carbon monoxide Absence of heat: hypothermia, frostbite Excess heat: heat stroke (hyperthermia)

Two Main Categories of Injury Unintentional Drowning Fall Fire Burn MVC Poisoning Intentional Suicide Self-Harm Assault Child Abuse Elder Abuse Domestic Violence

International Classification of Disease Diagnosis Codes Cause of Injury Codes ICD-9 (Non-fatal) ICD-10 (Deaths)

Diagnosis Codes Morbidity Required for Billing Numeric Updated > annually Phase out: 2013 Mortality Alphanumeric S00-T98 Updated every Oct. Oct. 1, 2013 Morbidity ICD-9 ICD-10

Diagnosis Codes - Examples Fractures Open Wound Crushing Burns Poisoning ICD-9ICD-10 Injury to… Head Neck Knee/Lower Leg Mult. Body Parts Burns & Corrosn Frostbite Poisoning S00-S09 S10-S19 S80-S89 T00-T07 T20-T32 T33-T35 T36-T50 See Reference Handout fx vault of skull; closed; no intercranial injury less than 1 hr LOC

External Cause of Injury Codes Morbidity Not required for billing Numeric preceded by E E800-E999 Allows for code for Place Updated > annually Phase out: 2013 State laws/coding rates vary IHS hospital d/c rates: high IHS ED & CHS rates: low Mortality Required for death certif Alphanumeric V01-Y98 Allows for code for Place Allows for code for Activity Updated every Oct. Oct. 1, 2013 Morbidity ICD-9 ICD-10

Diagnosis Codes - Examples MV Traffic Accidents Falls Suicide/Self-Inflicted Homicide (Assault) E810-E819 E880-E888 E950-E959 E960-E969 ICD-9ICD-10 Transport Accidents Falls Intentional Self-Harm Assault V01-V99 W00-W19 X60-X84 X85-Y09 See Reference Handout

Anatomy of an E-Code X X X. Y E Injury CategorySpecificity

Anatomy of an E-Code E MVC; collision w/other vehicle Injured person was a motorcyclist

Analysis of E-Codes E810.0 E819.1 E813.1 E814.7 E816.0 E819.0 E880.1 E884.0 E884.1 E885.2 E890.1 E890.3 E950.1 E955.0 E965.0 E966.0 MVCE800-E825 FallE880-E888 FireE890-E899 SuicideE950-E959 AssaultE960-E969 MVC invol. pedestrian Fall; playground equip.

(E880-E888) Fall from:…escalator…ladder …sidewalk curb…scaffolding …building/structure…diving …well…storm drain/manhole …playground…cliff …chair…wheelchair …bed…other furniture …commode…roller skates …skateboard…skis …snowboard…other/unspecified E-Code Example: Falls

Unspecified Fall Fall from sidewalk curb Fall from stairs Fall from chair Fall from commode Analysis of E-Codes E880.1 E880.9 E884.2 E884.6 E888 Falls E800-E888

E-Codes Limitations Records Not Always E-coded Miscoding & Inconsistent Coding Poor Chart Info = Nonspecific E-Code Dont Always Provide Desired Specificity Must Stay Apprised of Updates

National Center for Health Statistics Injury E Coded on Death Certificate by Coroner State Government E Coded at Hospital County Health Department FatalityHospitalization WISQARS Data System (Web- Based)

External Cause of Injury Coding References American Academy of Professional Coders World Health Organization CDC National Center for Health Statistics CDC article on improving E-coding

E-Code Exercise Searchable ICD-9 code: