Purpose: Applying injury-control-science to patient-safety efforts.
Objective: To examine hospital discharges data (N-code and E-codes) and describe the nature and scope of medical injuries. Medical injuries were defined as any injury occurring as result of diagnostic or therapeutic healthcare intervention. Injuries were identified through analysis of Wisconsin Office of Health Care Information (OHCI) Hospital Discharge Database-1997
Methods: Examination of ICD-9 diagnostic codes was performed on 1997 OHCI data for "therapeutic misadventures" (E870-E876), (n=607, rate=<1/1,000 hospital discharges). More comprehensive surveillance criteria were developed to accurately capture "medical injury" based on ICD E- and N- codes. The 1998 revision of ICD-9-Codes was used to search for potential codes indicating medical injury. One of the authors reviewed the criteria with three additional members of the research group to confirm expanded medical injury criteria.
Results: Expanded-screening criteria found 68,423 medical injuries, with 11.2/100 hospitalizations in Wisconsin for 1997. Greatest number of medical injuries occurred during surgical and medical procedures 32,697 injuries, 5.4/100 hospitalizations, drug related-(4.3/100), device/implant/graft injuries-(2.3/100), radiation-(0.2/100) and other/unknown-(0.8/100). Patients experiencing a medical injury stayed an average of 3.3 days longer in hospital, and incurred additional $12,087 charges per patient.
Conclusion: Medical injuries appear to be a common significant injury in Wisconsin. Our medical injury surveillance criteria should be validated and considered for use in national surveillance of hospital discharge data. The injury control model provides a potential theoretical framework and analytical tools to address the complex issue of medical injury.
Learning Objectives: 1. Participants will be able to articulate the process for surveillance of medical injury using expanded screening criteria developed by the WIRC. 2. Participants will be able to assess the utility of the application of the injury control model to medical injury surveillance and patient safety. 3. Partipants will be able to discuss and analyze the application of the expanded screening criteria for surveillance of medical injury
Keywords: Health Care Quality, Injury Control
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.