3182.0: Monday, October 22, 2001 - 5:15 PM

Abstract #29740

Estimation of the incidence of learning domain disabilities using statewide hospital discharge data sets

Anbesaw W. Selassie, DrPH1, Ja K. Gu, MSPH1, and Marlo Thomas-Koger, MPH2. (1) Biometry and Epidemiology, Medical University of South Carolina, 135 Rutledge Avenue, Suite 1148, P.O.Box 250551, Charleston, SC 29425, (843) 876-1140, aselassie@msn.edu, (2) Department of Family and Preventive Medicine, University of South Carolina, 6 Richland Medical Park, Columbia, SC 29203

Method: We identified 83,914 unduplicated survivors of TBI, stroke, and dementia from the statewide hospital discharge data set, 1997-99, using the ICD-9-CM codes consistent with these conditions. We defined learning domain disability (LDD) as any limitation in receiving, processing, remembering, and using information reducing the person's ability to profit from daily life experiences. By utilizing measures of severity and the clinical modifiers assigned to these diseases in a two-tier algorithm, we were able to estimate the proportion of survivors who might succumb to long-term disablement with LDD. We employed a multivariable loglinear model to validate the prediction of the algorithm and generated rates using the SC 1998 population. Results: 83% of the 58,107 survivors with stroke, 99% of the 18,931dementia survivors, and 67% of the 6,876 TBI survivors had some form of disability. The proportion of survivors with LDD was 55%, 99%, and 43% respectively for stroke, dementia, and TBI. The distribution of LDD by race and gender showed a male preponderance for TBI and stroke and a female preponderance for dementia. However, when senile dementia is excluded, the male to female ratio was comparable. Conclusion: This approach provides objective criteria to estimate the incidence of LDD. The proportions of survivors who develop LDD are very high suggesting the relevance of LDD as public health priority in SC. Due to the complexity of the underlying construct of learning disability, impairment-based imputation of LDD might furnish a robust estimate of incidence than phone surveys.

Learning Objectives: At the end of the session, participants will be able to: 1. Identify the four salient markers of learning disability and their link with stroke, traumatic brain injury (TBI), and dementia. 2. Express the sequence of steps to impute learning domain disability from a diagnosis of stroke, TBI, and dementia 3. Develop a plan to pilot-test these approaches in a specific jurisdiction where there is a hospital discharge data set

Keywords: Data/Surveillance, Disability

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.

The 129th Annual Meeting of APHA