2017 CSTE Annual Conference. Analysis and Reporting of Injury-Related Inpatient Hospitalizations Using ICD-10-CM-coded Administrative Billing Data

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217 CSTE Annual Conference Analysis and Reporting of

ICD-1-CM-coded Administrative Billing Data Svetla

Center (KIPRC) KIPRC is a bona fide agent for the

1 217 CSTE Annual Conference Analysis and Reporting of Injury-Related Inpatient Hospitalizations Using ICD-1-CM-coded Administrative Billing Data Svetla Slavova, PhD Kentucky Injury Prevention and Research Center (KIPRC) KIPRC is a bona fide agent for the Kentucky Department for Public Health, Cabinet for Health and Family Services

html Injury Hospitalization Subset of an

2 Available from: Injury Hospitalization Subset of an ICD-9-CM-coded State Hospital Discharge Data (HDD) Set

(Table 5): b. From the injury records, identify the subset of records that indicate an initial or subsequent encounter for treatment of an injury. Reference: ISW9.

3 Injury Hospitalization Subset of an ICD-1-CM-coded State Hospital Discharge Data (HDD) Set a. Identify injury records by searching the principal diagnosis field for any of the ICD-1-CM codes in the CDC case selection criteria for injury hospitalizations (Table 5): b. From the injury records, identify the subset of records that indicate an initial or subsequent encounter for treatment of an injury. Reference: ISW9. (216). injury Surveillance Workgroup 9. The Transition from ICD-9-CM to ICD-1-CM: Guidance for analysis and reporting of injuries by mechanism and intent.. Retrieved from Atlanta, GA. Available from

4 5,936 6,655 6,79 6,117 5,938 6,435 6,876 6,768 6,313 6,974 7,33 6,851 Injury-Related Inpatient Hospitalizations in Kentucky Acute Care Hospitals, by Quarter, , 7, 6, 5, 4, 3, 2, 1, 214Q1 214Q2 214Q3 214Q4 215Q1 215Q2 215Q3 215Q4 216Q1 216Q2 216Q3 216Q4 Total

5 Percentage of Injury Hospitalizations with Valid External Cause of Injury Codes 94% 93% 93.2% 93.2% 93.% 93.2% 92% 91% 9.8% 91.% 9.9% 91.7% 91.8% 91.6% 91.9% 9% 89% 88.7% 88% 87% 86% 214Q1 214Q2 214Q3 214Q4 215Q1 215Q2 215Q3 215Q4 216Q1 216Q2 216Q3 216Q4 % Injury Cases with a Cause of Injury (Based on Available Ecode) for Public Health. May 217. Data source: Kentucky Inpatient Claims, , Office of Health Policy, Cabinet

6 Percentage of Injury Hospitalizations with Valid External Cause of Injury Codes Estimated changes in level and trend through segmented regression 1 Perc_injury-records_with_external_cause_code t = β + β 1 *time t + β 2 *intervention t + β 3 *time-after-intervention t + e t, proc autoreg data=inputdataset outest=outputdataset; model perc_ecode_compl=time interv timeafter/method=ml dwprob; run; 1 Wagner AK, Soumerai SB, Zhang F, Ross Degnan D. Segmented regression analysis of interrupted time series studies in medication use research. J Clin Pharm Therap 22; 27(4),

7 Percentage of Injury Hospitalizations with Valid External Cause of Injury Codes Estimated changes in level and trend through segmented regression 1 Perc_injury-records_with_external_cause_code t = β + β 1 *time t + β 2 *intervention t + β 3 *time-after-intervention t + e t, Percentage of Injury Hospitalizations with Valid External Cause of Injury Code 95. Parameter Estimates Variable DF Estimate St. t Value Approx Error Pr > t Intercept <.1 Time Intervention Time-afterintervention y =.4395x y =.936x Wagner AK, Soumerai SB, Zhang F, Ross Degnan D. Segmented regression analysis of interrupted time series studies in medication use research. J Clin Pharm Therap 22; 27(4),

8 Injury Hospitalizations by Intent, Kentucky, Q1 214Q2 214Q3 214Q4 215Q1 215Q2 215Q3 215Q4 216Q1 216Q2 216Q3 216Q4 UNINTENTIONAL 85% 85% 84% 85% 84% 83% 84% 88% 88% 88% 88% 89% INTENTIONAL SELF- HARM 8% 8% 9% 9% 9% 9% 8% 9% 8% 9% 9% 8% ASSAULT 2% 3% 3% 2% 2% 3% 3% 2% 3% 3% 3% 3% UNDETERMINED 4% 4% 4% 4% 5% 5% 5% 1% 1% 1% 1% 1% 9% 89% 88% 87% 86% 85% 84% 83% 82% 81% 8% 2% 18% 16% 14% 12% 1% 8% 6% 4% 2% % UNINTENTIONAL INTENTIONAL SELF-HARM ASSAULT UNDETERMINED

9 Fall Injury Hospitalizations, Kentucky, ,77 2,997 2,951 3,67 3,35 3,6 3,4 3,21 3,16 3,5 3,232 3,155 3,99 3,278 3,253 3, FALLS

10 Firearm Injury Hospitalizations, Kentucky, FIREARM

11 Natural/Environmental Cause of Injury Hospitalizations, Kentucky, NATURAL/ENVIR

12 Poisoning Injury Hospitalizations, Kentucky, ,4 1,176 1,225 1,53 1,24 1,137 1,172 1,78 1,56 1,197 1,312 1,223 1,23 1,265 1,289 1, POISONING for Public Health. May 217. Data source: Kentucky Inpatient Claims, , Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

13 Kentucky Drug Poisoning Hospitalizations, ,4 1,2 1, 996 1,123 1,155 1, 985 1,88 1,122 1,37 1,7 1,149 1,267 1,147 1,154 1,29 1,235 1, DRUG POISONING (injury data set) for Public Health. May 217. Data source: Kentucky Inpatient Claims, , Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

14 Kentucky Drug Poisoning Hospitalizations, , 1,8 1,6 1,4 1,2 1, DRUG POISONING (injury data set) DRUG POISONING (any diagnosis or external cause code) for Public Health. May 217. Data source: Kentucky Inpatient Claims, , Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

Injury Hospitalizations with All Transportation Mechanism, Kentucky, 213-216 14 1,277 12

15 Injury Hospitalizations with All Transportation Mechanism, Kentucky, , ,171 1,67 1,141 1,55 1,96 1, ALL TRANSPORTATION

16 Motor Vehicle Traffic Injury Hospitalizations, Kentucky, MVTC Proposed ICD-1-CM external cause matrix Motor Vehicle-Traffic (MVT) MVT-Occupant MVT-Motorcyclist MVT-Pedal cyclist MVT-Pedestrian MVT-Other* MVT-Unspecified

17 Kentucky Injury Hospitalizations with Mechanism Other Pedestrian, OTHER PEDESTRIAN

18 Kentucky Injury Hospitalizations with Mechanism of Injury Other Transportation, OTHER TRANS

19 Suffocation Injury Hospitalizations in Kentucky, SUFFOCATION

20 Overexertion Injury Hospitalizations, Kentucky, OVEREXERTION

21 Kentucky Injury Hospitalizations with Mechanism Other Specified, Other Speficied and Classifiable OTHER SPECIFIED,CHILD/ADULT ABUSE OTHER SPECIFIED,FOREIGN BODY OTHER SPECIFIED,CLASSIFIABLE OTHER SPECIFIED,NOT ELSEWHERE CLASSIFIABLE Other Specified, Not Elsewhere Classifiable for Public Health. May 217. Data source: Kentucky Inpatient Claims, , Office of Health Policy, Cabinet

22 Number of Injury Cases Injury Hospitalizations with Other Specified Mechanism, Kentucky,

23 Injury Hospitalizations with Not Specified Mechanism, Kentucky, NOT SPECIFIED Not Specified ( X58 Exposure to Other Specified Factors)

24 Kentucky Injury Hospitalization Records with Place of Injury Codes, % 4% 35% 32% 32% 34% 35% 37% 35% 37% 41% 4% 4% 42% 41% 4% 39% 41% 3% 25% 2% 15% 16% 1% 5% % Percentage injury records with a code for place of injury occurrence

25 Kentucky Injury Hospitalization Records with Codes for Activity, % 12% 13% 12% 12% 12% 1% 1% 8% 6% 4% 3% 2% 2% 3% 3% 3% 2% 2% 3% 3% 2% 1% % Percentage injury records with a code for activity

Traumatic Brain Injuries (TBI) Treated in Acute Care Hospitals Thomas KE, Johnson RL. State injury indicators report: Instructions for Preparing 215 Data.

26 Traumatic Brain Injuries (TBI) Treated in Acute Care Hospitals Thomas KE, Johnson RL. State injury indicators report: Instructions for Preparing 215 Data. Atlanta (GA):Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; ury_indicator_instructions-a.pdf Hedegaard, H., Johnson, R. L., Warner, M., Chen, L. H., & Annest, J. L. (216). Proposed Framework for Presenting Injury Data Using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-1-CM) Diagnosis Codes. Natl Health Stat Report(89),

27 Traumatic Brain Injuries (TBI) Treated in Kentucky Acute Care Hospitals,

28 Percentage of TBI Hospitalizations TBI Hospitalizations in Kentucky, by Mechanism of Injury 6.% 5.% 54.1% 5.4% 4.% 3.% 29.4% 29.1% 2.% 12.2% 15.3% 1.% 4.3% 5.2%.% Fall MVT Struck by/against All other

Svetla Slavova ssslav2@email.uky.edu This presentation was supported by the Grant or Cooperative Agreement Number, 5 U17 CE2732-2, funded by the Centers for Disease Control and Prevention.

29 Svetla Slavova This presentation was supported by the Grant or Cooperative Agreement Number, 5 U17 CE2732-2, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.

TABLE 1a. Wisconsin Codes Project Inpatient Hospital Injury Report Major Cause of Injury FLORENCE COUNTY 2013

TABLE 1a. Wisconsin Codes Project Inpatient Hospital Injury Report Major Cause of Injury FLORENCE COUNTY 2013 TABLE 1a. Inpatient Hospital Injury Report Major Cause of Injury Maximum Injury Severity Major Cause Number Percent 100,000 Pop Average Sum Average Sum Average Cut/pierce Drown/submersion Fall Hot object/substance