2017 cste annual conference - university of kentucky...produced by the kentucky injury prevention...
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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
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
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
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jury
cas
es
Injury-Related Inpatient Hospitalizations in Kentucky Acute Care Hospitals, by Quarter, 2014 -2016
Total
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.
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
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jury
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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,
Percentage of Injury Hospitalizations with Valid External Cause of Injury Codes
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
Percentage of Injury Hospitalizations with Valid External Cause of Injury Codes
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.
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
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jury
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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%
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.
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
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jury
cas
es
Fall Injury Hospitalizations, Kentucky, 2013 - 2016
FALLS
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.
71
59
74
95
67
83
75 7477
119
77 77 79
114
106110
0
20
40
60
80
100
120
140
2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4
Nu
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jury
cas
es
Firearm Injury Hospitalizations, Kentucky, 2013 - 2016
FIREARM
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.
41
65
116
46
87 87
110
50
59
76
111
38
64
85
123
51
0
20
40
60
80
100
120
140
2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4
Nu
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jury
cas
es
Natural/Environmental Cause of Injury Hospitalizations, Kentucky, 2013 - 2016
NATURAL/ENVIR
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.
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
2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4
Nu
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jury
cas
es
Poisoning Injury Hospitalizations, Kentucky, 2013 - 2016
POISONING
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.
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
2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4
Nu
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jury
cas
es
Kentucky Drug Poisoning Hospitalizations, 2013 - 2016
DRUG POISONING (injury data set)
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.
0
200
400
600
800
1,000
1,200
1,400
1,600
1,800
2,000
2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4
Nu
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cas
es
Kentucky Drug Poisoning Hospitalizations, 2013 - 2016
DRUG POISONING (injury data set) DRUG POISONING (any diagnosis or external cause code)
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.
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
2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4
Nu
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cas
es
Injury Hospitalizations with “All Transportation” Mechanism, Kentucky, 2013 - 2016
ALL TRANSPORTATION
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.
648
327
902
744
568
820
904
715
610
710
842
700
573
791
954
865
0
200
400
600
800
1000
1200
2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4
Nu
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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
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.
0
5
10
15
20
25
30
35
40
45
2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4
Nu
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jury
cas
es
Kentucky Injury Hospitalizations with Mechanism “Other Pedestrian”, 2013- 2016
OTHER PEDESTRIAN
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.
81
120
208
107
75
180193
111
64
197
171181
149
260
276
186
0
50
100
150
200
250
300
2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4
Nu
mb
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jury
cas
es
Kentucky Injury Hospitalizations with Mechanism of Injury “Other Transportation”, 2013 - 2016
OTHER TRANS
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.
16
14
12
17
14
1920
19
9
1615
30
2625
28
24
0
5
10
15
20
25
30
35
2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4
Nu
mb
er o
f in
jury
cas
esSuffocation Injury Hospitalizations in Kentucky, 2013- 2016
SUFFOCATION
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.
0
10
20
30
40
50
60
2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4
Nu
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jury
cas
es
Overexertion Injury Hospitalizations, Kentucky, 2013 - 2016
OVEREXERTION
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
25
45
65
85
105
Nu
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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
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.
63
57
99
81 82
70
85
67
56
77
88
56
77 76
69 70
0
20
40
60
80
100
120
2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4
Nu
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jury
Cas
es
Injury Hospitalizations with “Other Specified” Mechanism, Kentucky, 2013 - 2016
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.
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
2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4
Nu
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cas
es
Injury Hospitalizations with “Not Specified” Mechanism, Kentucky, 2013 - 2016
NOT SPECIFIED Not Specified ( X58 Exposure to Other Specified Factors)
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.
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%
2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4
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Kentucky Injury Hospitalization Records with Place of Injury Codes, 2013 - 2016
Percentage injury records with a code for place of injury occurrence
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.
3%
1%
2% 2%
3%
3% 3% 2% 2%
3%
3%
13%
12%12% 12%
10%
0%
2%
4%
6%
8%
10%
12%
14%
2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4
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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
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.
Traumatic Brain Injuries (TBI) Treated in Kentucky Acute Care Hospitals, 2013 - 2016
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.
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.