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

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:

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

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  1. Injury Data IntroductionIntermediate Injury PreventionAugust 23-26, 2011 – Billings, MT

  2. 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

  3. 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?

  4. 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

  5. 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

  6. 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)

  7. 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)

  8. 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)

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

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

  11. Diagnosis Codes ICD-9 ICD-10 • Morbidity • Required for Billing • Numeric • 800-999 • Updated > annually • Phase out: 2013 • Mortality • Alphanumeric • S00-T98 • Updated every Oct. • Oct. 1, 2013 Morbidity

  12. Diagnosis Codes - Examples ICD-9 ICD-10 See Reference Handout

  13. External Cause of Injury Codes ICD-9 ICD-10 • 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

  14. Diagnosis Codes - Examples ICD-9 ICD-10 See Reference Handout

  15. Anatomy of an E-Code X X X . Y E Injury Category Specificity

  16. Anatomy of an E-Code 8 1 3 . 2 E MVC; collision w/other vehicle Injured person was a motorcyclist

  17. Analysis of E-Codes E810.0 E819.1 E813.1 E814.7 E814.7 E814.7 E814.7 E816.0 E819.0 E880.1 E884.0 E884.0 E884.0 E884.0 E884.1 E885.2 E890.1 E890.3 E950.1 E955.0 E965.0 E966.0 MVC E800-E825 MVC invol. pedestrian Fall; playground equip. Fall E880-E888 Fire E890-E899 Suicide E950-E959 Assault E960-E969

  18. E-Code Example: Falls (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

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

  20. E-Codes Limitations • Records Not Always E-coded • Miscoding & Inconsistent Coding • Poor Chart Info = Nonspecific E-Code • Don’t Always Provide Desired Specificity • Must Stay Apprised of Updates

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

  22. External Cause of InjuryCoding References • American Academy of Professional Coders http://www.aapc.com/ • World Health Organization http://www.who.int/classifications/icd/en/ • CDC National Center for Health Statistics http://www.cdc.gov/nchs/icd.htm • CDC article on improving E-coding http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5701a1.htm

  23. E-Code Exercise Searchable ICD-9 code: http://icd9cm.chrisendres.com/index.php

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