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CODES Oklahoma

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CODES Oklahoma

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    1. CODES Oklahoma C rash O utcome D ata E valuation S ystem

    3. CODES History Intermodal Surface Transportation Efficiency Act of 1991 required the National Highway Traffic Safety Administration (NHTSA) to analyze the benefits of safety belt and motorcycle helmet laws NHTSA could not comply because of absence of state data linking crashes to hospital records May 1992 NHTSA issued RFA for states who could demonstrate the technical ability to link crash and hospital data October 1992 Hawaii, Maine, Missouri, New York, Pennsylvania, Utah and Wisconsin became the first CODES states August 1997 Oklahoma became a CODES state Confidentiality and data sharing agreements with data owners were in place from the onset of the project As of 2002, there are 25 participating CODES states

    4. Oklahoma CODES Objectives Link Department of Public Safety (DPS) Crash data, OSDH health data and data from other sources to create extended research datasets Use the linked data to respond to report requests from OSDH, Oklahoma Highway Safety Office (OHSO), NHTSA and other entities Provide data to support educational and legislative efforts to reduce injuries due to crashes and to improve highway safety

    5. DPS: Crash Fatalities

    6. DPS: Number of Persons Injured in Crashes

    7. OSDH: Crashes in Oklahoma In Oklahoma, motor vehicle crashes are the leading cause of death and disability among persons 1-44 years of age. Each year, more than 600 persons die and more than 50,000 persons are injured in motor vehicle crashes in Oklahoma. Traffic Death rates per100,000 population are higher in Oklahoma than national rates (23.6 vs. 16.4 44% higher). Traffic death rates in rural areas of Oklahoma are higher than in metropolitan areas. Source: Injury Prevention Service Oklahoma State Department of Health (OSDH)

    8. DPS: Rural vs. Urban Crashes 61% of crashes involving fatal or severe injuries (KAB) occurred in Urban areas* 71% of fatal crashes occurred in Rural Areas Rural: 8 fatal per 100 injury crashes Urban: 2 fatal per 100 injury crashes

    9. Impact of Crashes on Public Health in Oklahoma

    10. Estimated Hospital Utilization Based on $10,632 Average charge per hospitalization (HCI, 1999) 4.8 days Average Length of Stay (HCI, 1999) 47,777 Injured or Killed in Crashes (OHSO, 2000) Estimated Hospital Charges and Patient Days from Crashes $507,965,064 total charges 229,330 patient days 11% of admissions

    11. CODES Goal Contribute to efforts to reduce the impact of crashes on the health of Oklahomans By linking data sets that contain information about the road conditions, vehicles and persons involved in crashes and emergency response and medical care for persons involved in crashes to answer questions about factors that influence health outcomes from crashes thereby providing information to describe the problem and contributing factors target interventions to reduce the impact of crashes on Oklahoman , and evaluate the effectiveness of interventions

    12. Types of Questions What are the personal and societal costs of non-use of seatbelts in Oklahoma? Why are crash death rates higher in rural Oklahoma and what can we do to reduce this disparity? What factors contribute to Oklahomas death rate from crashes being higher than national rate?

    13. Vehicle/Driver Data Sources

    14. Medical Care Data Sources

    15. What is Probabilistic Linking? Data elements needed from both files person identifiers name, SSN, birth date, etc. other shared fields -- event date, etc Match Weights calculated from similarities between selected fields in both files Record pairs with high match weights are considered linked records All CODES states use CODES2000 software to create linked datasets. This improves comparability of linkage results and subsequent reports among states.

    16. Probabilistic Linkage Strengths of linked data approach: Can address a much broader range of questions than crash data alone, thus improving the information on which public health and safety policy is based Can contribute to inter-agency coordination and cooperation in data management and reporting Challenges to data linkage: Data required for linkage is sometimes missing or unreliable, so care must be exercised to avoid spurious links Necessary use of personal identifiers in the linkage process creates concerns about confidentiality

    17. CODES Reports and Fact Sheets Aggregate Reports that do not directly or indirectly identify a person or health care provider Selected Reports: Child Passengers in Motor Vehicle Crashes, 1995-1997 Hospitalizations of Drivers 14-20 involved in Motor Vehicle Crashes in Oklahoma, 1995-1997 Crash-related hospital charges by type of restraint (all ages), 1995 and 1996 Inpatient length of stay and charges for crash victims, 1995-1997 by age and gender Length of stay and charges for alcohol-related crashes, 1995-1997

    18. What Others Have Done: As of 2000, participating states and NHTSA: Produced 64 Management reports, 85 Studies, 14 Fact sheets CODES helped get a graduated licensing law passed in Utah Missouri and Utah have Web interfaces for public access to linked CODES data

    19. Impact of Safety Equipment NHTSA report to Congress Safety belts cause a downward shift in the severity of injuries Average inpatient charge for unbelted drivers was more than 55 percent higher than for belted drivers ($13,937 vs. $9,004) About 16% of these charges were paid for by public sources Motorcycle helmet effectiveness ranged from 9 percent in preventing any kind of injury to 35 percent in preventing a fatality Average inpatient charge for motorcycle crashes was $14,377 for those who used helmets, and $15,578 for those who did not--8 percent higher charges for those electing to not wear a helmet. 23% of inpatient charges for motorcycle crashes were paid for by public sources

    20. What we could do... EMS Response/Scene/Transport time and health outcomes; Level of care (e.g. basic, paramedic, etc) Inpatient Hospitalization Types of Injuries; Procedures; Charges; Health Outcomes; Hospital utilization Death/FARS Factors influencing Injury Severity VIN Vehicle Characteristics and Crash Outcomes Driving History Conviction/departmental action history and crash outcomes

    21. Crash-Inpatient Data Linkage Inpatient hospitalization data at Health Care Authority (OHCA) -- 1995 data acquired and linked In 1998, hospital data moved to OSDH, Health Care Information (HCI) -- 1996-1997 data acquired and linked OSDH Reorganization Linkage of 1998-1999 crash-hospital data completed 1998-2000 linked de-identified crash-hospital data provided to CODES 1995-2000 data currently linked, 2001 in progress.

    22. Future At issuefuture accessibility of data for linkage, sharing and analysis. What can we do to facilitate the process of data sharing and linkage?

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