Assessing external cause of injury coding accuracy for transport injury hospitalizations
- PMID: 22016669
- PMCID: PMC3193508
Assessing external cause of injury coding accuracy for transport injury hospitalizations
Abstract
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.
Keywords: accuracy; discharge data; injury codes.
References
-
- Annest J.L, Fingerhut L.A, Gallagher S.S, et al. “Strategies to Improve External Cause-of-Injury Coding in State-based Hospital Discharge and Emergency Department Data Systems: Recommendations of the CDC Workgroup for Improvement of External Cause-of-Injury Coding.”. Morbidity and Mortality Weekly Report. 2008;57:1–8. - PubMed
-
- U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Recommended Actions to Improve External-Cause-of-Injury Coding in State-Based Hospital Discharge and Emergency Department Data Systems Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2009. Available at http://www.cdc.gov/injury/pdfs/ecode-a.pdf - PubMed
-
- Hunt J.P, Baker C.C, Fakhry S.M, Rutledge R.R, Ransohoff D, Meyer A.A. “Accuracy of Administrative Data in Trauma.”. Surgery. 1999;126:191–97. - PubMed
-
- Hunt J.P, Cherr G.S, Hunter C, et al. “Accuracy of Administrative Data in Trauma: Splenic Injuries as an Example.”. Journal of Trauma. 2000;49:679–88. - PubMed
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
Research Materials