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

This session covers injury data concepts, classification systems, and uses of injury data in prevention strategies. Learn about qualitative and quantitative data, common data sources, agents and categories of injury, and diagnosis codes.

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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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