Assessing external cause of injury coding accuracy for transport injury hospitalizations.

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Perspectives in health information management / AHIMA, American Health Information Management Association 01/2011; 8:1c.
Source: PubMed


External cause of injury codes (E codes) capture circumstances surrounding injuries. While hospital discharge data are primarily collected for administrative/billing purposes, these data are secondarily used for injury surveillance. We assessed the accuracy and completeness of hospital discharge data for transport-related crashes using trauma registry data as the gold standard. We identified mechanisms of injury with significant disagreement and developed recommendations to improve the accuracy of E codes in administrative data. Overall, we linked 2,192 (99.9 percent) of the 2,195 discharge records to trauma registry records. General mechanism categories showed good agreement, with 84.7 percent of records coded consistently between registry and discharge data (Kappa 0.762, p < .001). However, agreement was lower for specific categories (e.g., ATV crashes), with discharge records capturing only 70.4 percent of cases identified in trauma registry records. Efforts should focus on systematically improving E-code accuracy and detail through training, education, and informatics such as automated data linkages to trauma registries.

Download full-text


Available from: Stephen M Bowman, Jan 15, 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Occupational injury researchers typically use payer to identify work-related injuries in hospital discharge records. Many trauma registries contain a work-related field, independent of payer. Linked trauma registry and hospital discharge records were used to assess data field concordance and to assess the validity of using payer or external cause of injury (E-codes) to identify work-related injuries. Methods: Washington State Trauma Registry records were linked to hospital discharges (year 2009). Results: There was substantial agreement between Washington State Trauma Registry and hospital discharge records for workers' compensation as primary payer. E-code based methods of identifying occupational injuries had high specificity (more than 99%) but low sensitivity (less than 14%). Payer was 76% sensitive and 98% specific. Conclusions: This study found substantial agreement for data fields key to occupational injury surveillance and research. Nevertheless, many work-related injuries could not be identified using hospital discharge records.
    Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 08/2014; 56(8):878-85. DOI:10.1097/JOM.0000000000000198 · 1.63 Impact Factor