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Inj Prev. Dec 2002; 8(4): 332–337.
PMCID: PMC1756568

Traps for the unwary in estimating person based injury incidence using hospital discharge data

Abstract

Background: Injuries resulting in admission to hospital provide an important basis for determining priorities, emerging issues, and trends in injury. There are, however, a number of important issues to be considered in estimating person based injury incidence using such data. Failure to consider these could result in significant overestimates of incidence and incorrect conclusions about trends.

Aim: To demonstrate the degree to which estimates of the incidence of person based injury requiring hospital inpatient treatment vary depending on how one operationally defines an injury, and whether or not day patients, readmissions, and injury due to medical procedures are included.

Method: The source of data for this study was New Zealand's National Minimum Dataset. The primary analyses were of a dataset of all 1989–98 discharges from public hospital who had an external cause of injury and poisoning code assigned to them.

Results: The results show that estimates of the incidence of person based injury vary significantly depending on how one operationally defines an injury, and whether day patients, readmissions, and injury due to medical procedures are included. Moreover the effects vary significantly by pathology and over time.

Conclusions: (1) Those using New Zealand hospital discharge data for determining the incidence of injury should: (a) select cases which meet the following criteria: principal diagnosis injury only cases, patients with day stay of one day or more, and first admissions only, (b) note in their reporting that the measure is an estimate and could be as high as a 3% overestimate. (2) Other countries with similar data should investigate the merit of adopting a similar approach. (3) That the International Collaborative Effort on Injury Statistics review all diagnoses within International Classification of Diseases 9th and 10th revisions with a view to reaching consensus on an operational definition of an injury.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Langley JD. Experiences using New Zealand's hospital based surveillance system for injury prevention research. Methods Inf Med. 1995 Sep;34(4):340–344. [PubMed]
  • Alsop JC, Langley JD. Determining first admissions in a hospital discharge file via record linkage. Methods Inf Med. 1998 Jan;37(1):32–37. [PubMed]
  • Smith GS, Langlois JA, Buechner JS. Methodological issues in using hospital discharge data to determine the incidence of hospitalized injuries. Am J Epidemiol. 1991 Nov 15;134(10):1146–1158. [PubMed]

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