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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics. Defining injuries with emergency department data: a recommendation from the United States. Lois Fingerhut.
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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics Defining injuries with emergency department data: a recommendation from the United States Lois Fingerhut
US “traditional” NHAMCS-ED injury definition and inclusion criteria Measure of burden of injury on the ED • Reason for Visit Classification (up to 3) • All ICD–9– CM diagnoses from Chapter 17 • All ICD-9-CM external causes from Supplementary Classification • Both the diagnoses and the external cause codes can include complications of care and adverse effects codes. • Check box “Is visit related to injury, or poisoning or adverse effect of medical treatment?”
Recommended incidence-based injury visit definition • Initial visit to an ED with either • a first-listed injury diagnosis regardless of any mention of an external cause of injury or • a valid external cause of injury. • Visits with a first-listed diagnosis code of either complications of care or an adverse effect are excluded.
Modified recommended injury visit definition • A first-listed injury diagnosis regardless of any mention of an external cause of injury code, or • Visit witha valid first-listed external cause of injury • Visits with a first-listed diagnosis code of either complications of care or an adverse effect are excluded. • Initial visit status is not part of this definition as the variable was not introduced until 2001.
Trends in number of injury visits to EDs, alternative definitions: US, 1995-2004
Derivation of recommended definition for 2004 number of visits