The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #71858

Harold B. Weiss, MPH, PhD¹, Rovshan Muratovich Ismailov², Bruce A. Lawrence, PhD³, and Ted Miller³. (1) Center for Injury Research and Control, University of Pittsburgh, 200 Lothrop St., Suite B400, Pittsburgh, PA 15213, 412-648-9290, hw@injurycontrol.com, (2) Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, 200 Lothrop St, Suite B400, Pittsburgh, PA 15213, (3) Pacific Institute for Research and Evaluation, 11710 Beltsville Drive, Suite 300, Calverton, MD 20705-3102

Background - Since 10/96, hospital discharge data (HDD) have included codes for designating perpetrator relationship in assaults. For intentional injuries, guidelines require using E-codes for the injury mechanism and another (E967) identifying perpetrator relationships. Completeness and characteristics of these codes have not been studied on a multi-state level. Methods - 1997 HDD were solicited from states with good E-coding. Data were received from 19 states (51.9% of women 15-49). For assaulted women, a regression model was constructed to understand factors associated with perpetrator code assignment using age, payment source, pregnancy status, race and severity. Results - Among 137,887 injured women 15-49, there were 7,402 assaults (5.4%). Among assaults, perpetrator coding was poor (8.8%) and among those that were perpetrator coded, 83.7% were spouse/partner related. Older women were more likely to have a perpetrator code (P <.001). Those paid by a private source were 42.9 percent more likely to have a perpetrator code (P =.007). Pregnant women were 7 times more likely to have a perpetrator code (P <.001). Non-white women were 66.8% less likely to have a perpetrator code (P<.001) than white. Conclusions - The poor use of perpetrator codes in HDD minimizes their usefulness for surveillance of serious injury from intimate partner violence. An implication of this research is the need to understand the gaps and strengthen the completeness of perpetrator documentation and coding. The findings suggest areas to be cautious of when interpreting the results from existing IPV surveillance systems.

Learning Objectives:

• At the conclusion of the sessions the participant will be able to:
• 1. Identify how perpetrator E-coding is used in hospital discharge data.
• 2. Recognize the limitations of the completeness of ICD-9 CM perpetrator coding.
• 3. Recognize the biases inherent in perpetrator coding in ICD-9 CM.

Keywords: Violence, Surveillance

Presenting author's disclosure statement:
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.