Health Care Cost and Utilization Patterns of Crash Victims In Illinois

1. Health Care Cost and Utilization Patterns of Crash Victims In Illinois Mehdi Nassirpour, Ph.D. Susan Fitzpatrick, Xinrong Lei Illinois Department of Transportation Division of Traffic Safety CODES Workgroup

2. CODES in Illinois • In 2005 the National Highway Safety Administration (NHTSA) awarded the Illinois Department of Transportation (IDOT) a grant to develop a CODES (Crash Outcome Data Evaluation System) program. This project has been based on collaboration between IDOT and the Illinois Department of Public Health (IDPH) and other state agencies. CODES Workgroup

3. CODES Project and Division of Traffic Safety • How does CODES project fit with other Highway Safety Programs? • Who are the audience? • Has it been coordinated with ITRCC? • How do program staff react toward the CODES? • What have we done to address these concerns? CODES Workgroup

4. Proposed CODES Data System for the State of Illinois Statewide Police-Reported Crash Data FARS Data Death Certificate Fatal Data Head and Spinal Cord Injury Data Hospital Discharge Data Trauma Registry Trauma Registry Inpatient Information Police Crash Report Trauma Registry/ Head/Spinal Cord Injury Hospital Discharge Data Outpatient Information Statewide Police-Reported Crash Data Emergency Medical Data CODES Workgroup

5. Objectives • Link 2005 crash data to hospital inpatient discharge data. • Provide hospital costs and utilization patterns among those who were injured or died as a result of traffic crashes in Illinois. • Provide descriptive information on number of discharges, average length of stay, primary injuries, types of crash controlling for demographics (age and gender), belt status, vehicle type, expected payment source and discharge status and several other factors. • Develop analytical models to study the relationship between hospital charges, belt status and alcohol impairment, controlling for several demographic, vehicle and crash characteristics. CODES Workgroup

6. Linkage Project • 2005 Person-level Illinois Crash Records • 2005 Consolidated Single Record Hospital Inpatient Admissions • 2005 Hospital Inpatient Admissions with Injuries • Self Match using CODES2000 • Consolidated multiple admissions into a single record • Imputed Linkages CODES Workgroup

7. Data Linked Crash Hospital Inpatient CODES Workgroup

8. Crash to Consolidated Hospital Inpatient Linkage Results CODES Workgroup

9. Potential applications • Effectiveness of helmets and safety belts • Alcohol Impairment • Understanding the nature of crashes and injuries • Total Hospital Charges and Length of Stay • Identifying causes of motor vehicle injuries • Improving data quality CODES Workgroup

10. Theoretical Diagram Injury Demographics Charge Vehicle Impairment Belt Status Crash Discharge Status CODES Workgroup

11. Analyses • Descriptive Statistics (Freq. Percent, and Average) on hospital charges and belt status controlling for several factors. • Use multivariate Statistics (Regular Regression and Logistic Regression) to predict hospital charge, belt status, and alcohol impairment controlling for selected factors (Proc MI and MIANALYZE procedures in SAS used to perform these analyses). CODES Workgroup

12. Descriptive Results • Crash occupants hospitalized as inpatients: • 5,235 average number of linked records • $55,588 estimated average hospital charges (in 2009 Dollars) • 7.0 estimated average length of stay CODES Workgroup

13. Age Group CODES Workgroup

14. Gender – Average Charge CODES Workgroup

15. Payer - Linked and Average Charge CODES Workgroup

16. Injured Body Regions CODES Workgroup

17. Injury - Linked and Average Charge CODES Workgroup

18. Discharge Status – Charges and LOS CODES Workgroup

19. Vehicle Type – Charges and LOS CODES Workgroup

20. Vehicles Involved CODES Workgroup

21. Belt Status (Passenger Cars & Light Trucks) – Charges and LOS CODES Workgroup

22. KABCO Charges and LOS CODES Workgroup

23. KABCO Percentages CODES Workgroup

24. Severity - Charges and LOS CODES Workgroup

25. Number of Linked Records and Estimated Hospital Charge by Belt Status and Injury Type (KABCO) – Passenger Cars & Light Trucks CODES Workgroup

26. Estimated Hospital Charge By Belt Status and Gender – Passenger Cars & Light Trucks CODES Workgroup

27. Estimated Hospital Charge By Belt Status and Location – Passenger Cars & Light Trucks CODES Workgroup

28. Estimated Hospital Charge by Belt Status and Alcohol Impairment – Passenger Cars & Light Trucks CODES Workgroup

29. Helmet Status – Charges and LOS CODES Workgroup

30. Percent Motorcycle Injuries by Police Reported Injury Type and Helmet Status Total helmeted =191 Total not Helmeted =493 CODES Workgroup

31. Percent Head Injuries by Helmet Status Total helmeted =191 Total not Helmeted =493 CODES Workgroup

32. Alcohol Status – Charges and LOS CODES Workgroup

33. Speeding/Not Speeding– Charges and LOS CODES Workgroup

34. Police Reported Injury– Charges CODES Workgroup

35. Severity of Head Injuries– Charges Total N=706 Total Head Injury = 273 (39%) CODES Workgroup

36. Upper and Lower Extremity Injuries– Charges Total N=706 Total Upper Extremities 333 (47%) Total Upper Extremities= 379 (54%) CODES Workgroup

37. Crash Severity– Charges CODES Workgroup

38. Intersection Related Crash– Charges CODES Workgroup

39. Time of Crash– Charges CODES Workgroup

40. Crash Type– Charges CODES Workgroup

41. Results based on Multivariate Analyses CODES Workgroup

42. List of Variables Used CODES Workgroup

43. Total Charge Per Discharge Controlling for Selected Person, Vehicle and Environmental Variables CODES Workgroup

44. Results of MIANALYZE on BELTED Controlling for Selected Person, Vehicle and Environmental Variables CODES Workgroup

45. Future Plan • Complete the analysis • Validate and compare our numbers with other states’ data through NHTSA and other CODES states • Share the results with following groups: • ITRCC members • CODES Advisory Committee members • Highway Safety Program Committee members • Use the linked data as source database for the highway safety and injury prevention groups • Repeat the data linkages and analyses using 2006 or more recent Crash and Health Care Data including EMS CODES Workgroup

46. Mehdi Nassirpour, Ph.D. Illinois Department of Transportation mehdi.nassirpour@illinois.gov Website address for this presentation http://www.dot.state.il.us/trafficsafety/tsevaluation.html CODES Workgroup

47. QUESTIONS ? CODES Workgroup