Reducing the Burden of Injury Advancing Prevention and Treatment (1999) / Chapter Skim
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3 Surveillance and Data
3 Surveillance and Data
Pages 60-81
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From page 60... ...
a reduction in the incidence or severity of the target injury, but also resulting in an unintended adverse outcome; (3) little or no effect on the target injury and no unintended outcomes (other than the cost of implementation)
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From page 61... ...
· The mechanisms of airbag-associated deaths were elucidated through the Special Crash Investigation (SCI) program at the National Highway Traffic Safety Administration (NHTSA)
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From page 62... ...
However, significant impediments to effective injury surveillance remain, notably the high costs of development and maintenance of surveillance systems. Therefore, priority attention should be given to the improvement or expansion of existing data systems and to the development of efficient strategies for linking data across systems to gather additional and more complex information.
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From page 63... ...
Since 1992, the Emergency Department Component of the National Hospital Ambulatory Medical Care Survey (NHAMCS) has routinely included Ecodes (Burt and Fingerhut, 1998~.
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From page 64... ...
Free text, electronically accessible to searching, permits a fuller understanding of the circumstances surrounding an injury and can help identify specific injuries missed by conventional coding (Smith and Langley, 19981. The committee recommends that a high priority be directed at ensur~ng uniform and reliable coding of both the external cause and the nature of the injury using the ICD on all health systems data, particularly on hospital and emergency department discharge records.
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From page 65... ...
Although procedures exist for estimating distributions by mechanism and intent, given incomplete data, the lack of universal external cause coding of hospital discharges remains a significant impediment to the optimal use of these databases for studying the epidemiology of injury. National data on nonfatal injuries resulting in a visit to an outpatient setting (e.g., emergency department, clinic, physician office)
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From page 66... ...
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From page 68... ...
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From page 69... ...
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From page 70... ...
. NEISS obtains statistical information through surveillance of 101 hospital emergency departments and through follow-up studies.
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From page 71... ...
Based on the promising results of this pilot and discussions with staff at both the NCIPC and the CPSC, the committee recommends an expansion of NEISS data collection to include all injuries treated in emergency departments to increase knowledge of the causes and severity of nonfatal injuries. Furthermore, an expanded NEISS could greatly benefit the injury field because it would provide a new and important tool for gathering national estimates and monitoring national trends in injury morbidity, for identifying emerging problems, for evaluating interventions through follow-up studies, and for providing data for policy decisions.
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From page 72... ...
For example, data from FARS was able to document the benefits of legislation that raised the minimum purchase age for alcoholic beverages (Chapter 5~. The committee considered the merits and feasibility of establishing a comprehensive fatal injury surveillance system that would collect detailed data on all fatal injuries not currently included in existing fatality surveillance systems and that would be coordinated with existing systems.
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From page 73... ...
established the Medical Examiner and Coroner Information Sharing Program, to improve the quality of data on death certificates and to increase the availability of those data for scientific research (NCEH, 1998~. The committee recommends the development of a fatal intentional injury surveillance system, modeled after FARS, for all homicides and suicides.
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From page 74... ...
Unique challenges will be presented in the collection of data for this system, compared to the collection of data about motor vehicle crashes, because some of the desired information, particularly about the perpetrator, motivations, and weapons may not be known in every case. The committee believes that the development of a fatal intentional injury surveillance system is essential for a nationwide effort in reducing fatal intentional injuries.
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From page 75... ...
State and local data on injury hospitalizations are generally available from two principal sources: trauma registries and uniform hospital discharge data. The scope and quality of hospital-based trauma registries have improved significantly over the past several years, and nearly one-half of all states now maintain such registries on a statewide basis (Shapiro et al., 1994; Rutledge, 1995~.
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From page 76... ...
Typically, however, deaths are included regardless of whether they occur in the emergency department or after admission to the hospital. Most statewide registries collect data only from trauma centers.
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From page 77... ...
Although statewide uniform hospital discharge data do not include information on injury deaths that occur in the field or during transport, they have become a valuable source of information for states and local communities. In particular, when linked to vital statistics or medical examiner data, they provide a complete picture of all trauma severe enough to result in death or hospitalization.
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From page 78... ...
CODES were initially designed to develop comprehensive data for determining the impact of safety-belt and motorcycle helmet use on the incidence and severity of injuries, health care costs, and outcome. The implementation of CODES required the linkage of police crash reports with death certificate or medical examiner data and health care data (including emergency medical services data, emergency department data, hospital discharge data, and occasionally data from the insurance claims)
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From page 79... ...
the development of a fatal intentional injury surveillance system, based on the successful FARS data system; (4) extending the use of trauma registries to monitor long-term outcome following injury; and (5)
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From page 80... ...
1991. Report on the Need to Collect External Cause of Injury Codes in Hospital Discharge Data.
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From page 81... ...
1996. Airbags and children: Results of a National Highway Traffic Safety Administration special investigation into actual crashes.
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