Injury coding and hospital discharge data

Article Abstract:

Hospital records, particularly hospital discharge summary data, are currently inadequate to allow studies which can be used to assess, measure and develop preventive strategies for nonfatal injuries. With only modest adjustment current methods of data collection are most probably adequate for this purpose. Particularly at fault on hospital records is the frequent absence of external conditions which give rise to the incident, known as "E codes" (for external cause). This article describes the various E codes which are established and their proper usage. Presently only four states mandate E codes: Washington, New York, Wisconsin and California. Although one argument against the collection of E codes is the cost of acquiring such data, experience in Washington State has shown the cost to be about 75 cents per record, and the aggregate cost in the entire state is estimated to be $85,900. Currently there is no financial incentive for hospitals to collect this information. In addition there exist neither standardized terms for reporting nor a responsible government agency accountable for the collection of such data. E-coded discharge summaries are a potentially important means of collecting data and developing schemes of accident prevention. The implementation of a mandated or frequent acquisition of E-code data will require standardization, the development of guidelines, education of responsible health care providers and financial reimbursement mechanisms. An institutional structure responsible for the collection and evaluation of such data must also be developed.

Case studies, Evaluation, Measurement, Medical history taking, Wounds and injuries, Medical records, Medical statistics, Medical record linkage

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Trends in death associated with traumatic brain injury, 1979 through 1992: success and failure

Article Abstract:

Traumatic brain injury (TBI) resulting from motor vehicle accidents has declined substantially, while brain injury associated with firearms has increased. Between 1979 and 1992, TBI death rate from motor vehicles dropped 42%, even with an increase in registered vehicles and travel miles. Between 1984 and 1992, the death rate linked to firearms increased 13% to 44% in 1992. Annually, more than 51,000 people in the U.S. suffered a TBI that led to their death. Overall, the death rate associated with TBI declined 22% from 24.6 per 100,000 people in 1979 to 19.3 per 100,000 people in 1992. Firearms are the leading cause of death due to traumatic brain injury. Six times more males than females died from firearm-related injuries in 1992.

Causes of, Brain death

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National medical association surgical section position paper on violence prevention: a resolution of trauma surgeons caring for victims of violence

Article Abstract:

Violence in America continues to increase and has not been tackled effectively. Physicians and health care workers want to begin the process of working on this social and public health problem, but professionals and conscientious adults from a wide spectrum can answer the call to curtail violence and prevent serious injury. Those most affected are males, blacks and the uninsured. More than 40,000 patients with trauma injuries enter hospitals yearly. The number one cause of death among young African Americans is homicide related to guns. For all American men aged 15-19, the homicide rate increased 154% between 1985 and 1991. Families and society as a whole are seriously impacted by the rise of violent acts.

Prevention, Violence

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