2017 cste annual conference - university of kentucky...produced by the kentucky injury prevention...

KIPRC is a bona fide agent for the Kentucky Department for Public Health, Cabinet for Health and Family Services

Analysis and Reporting of Injury-Related Inpatient Hospitalizations Using ICD-10-CM-coded Administrative Billing Data

Svetla Slavova, PhDKentucky Injury Prevention and Research Center (KIPRC)

2017 CSTE Annual Conference

Available from:https://www.cdc.gov/injury/stateprograms/indicators.html

Injury Hospitalization Subset of

an ICD-9-CM-coded State Hospital Discharge Data (HDD) Set

https://www.cdc.gov/injury/stateprograms/indicators.html

Injury Hospitalization Subset of

an ICD-10-CM-coded State Hospital Discharge Data (HDD) Set

a. Identify injury records by searching the principal diagnosis field for any of the ICD-10-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. (2016). injury Surveillance Workgroup 9. The Transition from ICD-9-CM to ICD-10-CM: Guidance for analysis and reporting of injuries by mechanism and intent. . Retrieved from Atlanta, GA. Available from http://www.safestates.org/?page=ISWReports

http://www.safestates.org/?page=ISWReports

Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

5,9

36

6,6

55

6,7

90

6,1

17

5,9

38

6,4

35

6,8

76

6,7

68

6,3

13

6,9

74

7,3

03

6,8

51

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Nu

mb

er o

f in

jury

cas

es

Injury-Related Inpatient Hospitalizations in Kentucky Acute Care Hospitals, by Quarter, 2014 -2016

Total


90.8% 91.0%

90.9%91.7%

91.8%

93.2%

93.2%

88.7%

91.6%

93.0%

91.9%

93.2%

86%

87%

88%

89%

90%

91%

92%

93%

94%

2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Nu

mb

er o

f in

jury

cas

es

Percentage of Injury Hospitalizations with Valid External Cause of Injury Codes

% Injury Cases with a Cause of Injury (Based on Available Ecode)

1Wagner AK, Soumerai SB, Zhang F, Ross‐Degnan D. Segmented regression analysis of interrupted time series studies in

medication use research. J Clin Pharm Therap 2002; 27(4), 299-309.

Estimated changes in level and trend through segmented regression1

Perc_injury-records_with_external_cause_code t= β0 + β1*timet + β2*interventiont + β3*time-after-interventiont + et,


proc autoreg data=inputdataset outest=outputdataset; model perc_ecode_compl=time interv timeafter/method=ml dwprob;run;

1Wagner AK, Soumerai SB, Zhang F, Ross‐Degnan D. Segmented regression analysis of interrupted time series studies in

medication use research. J Clin Pharm Therap 2002; 27(4), 299-309.

y = 0.4395x + 93.129 y = 0.936x + 88.882

75.0

77.0

79.0

81.0

83.0

85.0

87.0

89.0

91.0

93.0

95.0

-8 -6 -4 -2 0 2 4 6

Percentage of Injury Hospitalizations with Valid External Cause of Injury Code

Estimated changes in level and trend through segmented regression1

Perc_injury-records_with_external_cause_code t= β0 + β1*timet + β2*interventiont + β3*time-after-interventiont + et,

Parameter Estimates

Variable DF EstimateSt.

t ValueApprox

Error Pr > |t|

Intercept 1 93.129 0.5455 170.71 <.0001

Time 1 0.4395 0.1513 2.9 0.0198

Intervention 1 -3.7502 0.9179 -4.09 0.0035

Time-after-intervention

1 0.4965 0.295 1.68 0.1308



Injury Hospitalizations by Intent, Kentucky, 2014 - 2016

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

INTENTIONAL SELF-HARM ASSAULT UNDETERMINED

80%

81%

82%

83%

84%

85%

86%

87%

88%

89%

90%

Nu

mb

er o

f in

jury

cas

es

UNINTENTIONAL

2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

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%


2,707

2,997 2,9513,067 3,035 3,060 3,040 3,021

3,106 3,0503,232 3,155 3,099

3,278 3,2533,350

0

500

1000

1500

2000

2500

3000

3500

4000

2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Nu

mb

er o

f in

jury

cas

es

Fall Injury Hospitalizations, Kentucky, 2013 - 2016

FALLS


71

59

74

95

67

83

75 7477

119

77 77 79

114

106110

0

20

40

60

80

100

120

140


Nu

mb

er o

f in

jury

cas

es

Firearm Injury Hospitalizations, Kentucky, 2013 - 2016

FIREARM


41

65

116

46

87 87

110

50

59

76

111

38

64

85

123

51

0

20

40

60

80

100

120

140


Nu

mb

er o

f in

jury

cas

es

Natural/Environmental Cause of Injury Hospitalizations, Kentucky, 2013 - 2016

NATURAL/ENVIR


1,040

1,1761,225

1,0531,024

1,1371,172

1,078 1,056

1,197

1,312

1,223 1,2031,265 1,289

1,158

0

200

400

600

800

1000

1200

1400


Nu

mb

er o

f in

jury

cas

es

Poisoning Injury Hospitalizations, Kentucky, 2013 - 2016

POISONING


996

1,1231,155

1,000 985

1,0881,122

1,0371,007

1,149

1,267

1,147 1,1541,209 1,235

1,101

0

200

400

600

800

1,000

1,200

1,400


Nu

mb

er o

f in

jury

cas

es

Kentucky Drug Poisoning Hospitalizations, 2013 - 2016

DRUG POISONING (injury data set)


0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000


Nu

mb

er o

f in

jury

cas

es

Kentucky Drug Poisoning Hospitalizations, 2013 - 2016

DRUG POISONING (injury data set) DRUG POISONING (any diagnosis or external cause code)


747

471

1,171

866

658

1,067

1,141

856

685

945

1,055

931

753

1,096

1,277

1,086

0

200

400

600

800

1000

1200

1400


Nu

mb

er o

f in

jury

cas

es

Injury Hospitalizations with “All Transportation” Mechanism, Kentucky, 2013 - 2016

ALL TRANSPORTATION


648

327

902

744

568

820

904

715

610

710

842

700

573

791

954

865

0

200

400

600

800

1000

1200


Nu

mb

er o

f in

jury

cas

es

Motor Vehicle Traffic Injury Hospitalizations, Kentucky, 2013 - 2016

MVTC

Proposed ICD-10-CM external cause matrix

Motor Vehicle-Traffic (MVT)

MVT-Occupant

MVT-Motorcyclist

MVT-Pedal cyclist

MVT-Pedestrian

MVT-Other*

MVT-Unspecified


0

5

10

15

20

25

30

35

40

45


Nu

mb

er o

f in

jury

cas

es

Kentucky Injury Hospitalizations with Mechanism “Other Pedestrian”, 2013- 2016

OTHER PEDESTRIAN


81

120

208

107

75

180193

111

64

197

171181

149

260

276

186

0

50

100

150

200

250

300


Nu

mb

er o

f in

jury

cas

es

Kentucky Injury Hospitalizations with Mechanism of Injury “Other Transportation”, 2013 - 2016

OTHER TRANS


16

14

12

17

14

1920

19

9

1615

30

2625

28

24

0

5

10

15

20

25

30

35


Nu

mb

er o

f in

jury

cas

esSuffocation Injury Hospitalizations in Kentucky, 2013- 2016

SUFFOCATION


0

10

20

30

40

50

60


Nu

mb

er o

f in

jury

cas

es

Overexertion Injury Hospitalizations, Kentucky, 2013 - 2016

OVEREXERTION


5

25

45

65

85

105

Nu

mb

er o

f in

jury

cas

esKentucky Injury Hospitalizations with Mechanism “Other Specified”, 2013 -2016

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


63

57

99

81 82

70

85

67

56

77

88

56

77 76

69 70

0

20

40

60

80

100

120


Nu

mb

er o

f In

jury

Cas

es

Injury Hospitalizations with “Other Specified” Mechanism, Kentucky, 2013 - 2016


75

84

66

91

70

80

9085

75

90

119

140

125 124

154

124

0

20

40

60

80

100

120

140

160

180


Nu

mb

er o

f in

jury

cas

es

Injury Hospitalizations with “Not Specified” Mechanism, Kentucky, 2013 - 2016

NOT SPECIFIED Not Specified ( X58 Exposure to Other Specified Factors)


32%

16%

32%

34% 35%37%

35%37%

41%40% 40%

42%41%

40% 39%41%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%


Nu

mb

er o

f in

jury

cas

es

Kentucky Injury Hospitalization Records with Place of Injury Codes, 2013 - 2016

Percentage injury records with a code for place of injury occurrence


3%

1%

2% 2%

3%

3% 3% 2% 2%

3%

3%

13%

12%12% 12%

10%

0%

2%

4%

6%

8%

10%

12%

14%


Nu

mb

er o

f in

jury

cas

es

Kentucky Injury Hospitalization Records with Codes for Activity, 2013 - 2016

Percentage injury records with a code for activity

Hedegaard, H., Johnson, R. L., Warner, M., Chen, L. H., & Annest, J. L. (2016). Proposed Framework for Presenting Injury Data Using the International Classification of Diseases,Tenth Revision, Clinical Modification (ICD-10-CM) Diagnosis Codes. Natl Health Stat Report(89), 1-20.https://www.ncbi.nlm.nih.gov/pubmed/26828779

Traumatic Brain Injuries (TBI) Treated in Acute Care Hospitals

Thomas KE, Johnson RL. State injury indicators report: Instructions for Preparing 2015 Data. Atlanta (GA):Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2017.https://www.cdc.gov/injury/pdfs/2015_state_injury_indicator_instructions-a.pdf

https://www.ncbi.nlm.nih.gov/pubmed/26828779

https://www.cdc.gov/injury/pdfs/2015_state_injury_indicator_instructions-a.pdf


Traumatic Brain Injuries (TBI) Treated in Kentucky Acute Care Hospitals, 2013 - 2016


54.1%

29.4%

4.3%

12.2%

50.4%

29.1%

5.2%

15.3%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

Fall MVT Struck by/against All other

Per

cen

tage

of

TBI H

osp

ital

izat

ion

s

TBI Hospitalizations in Kentucky, by Mechanism of Injury

2014 2016

Svetla [email protected]

This presentation was supported by the Grant or Cooperative Agreement Number, 5 U17 CE002732-02, 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.

2017 cste annual conference - university of kentucky...produced by the kentucky injury prevention...

Documents