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

Abstract #72317

Robert Campbell, JD, PhD¹, Aurora Sanchez-Anguiano, MD, PhD², Douglas Bradham, DrPH³, and Dennis C. Werner, MHA¹. (1) Health Informatics Division, VA Patient Safety Center, Tampa, Florida, 11605 N. Nebraska Ave, Tampa, FL 33612, 813-558-3962, rrcampbell@sprynet.com, (2) Epidemiology, VA Patient Safety Center, Tampa, 11605 N. Nebraska Ave, Tampa, FL 33612, (3) Health Economics, Patient Safety Center, Tampa, 11605 N. Nebraska Ave, Tampa, FL 33612

Background: Injuries account for significant morbidity, mortality, and costs in the United States. Hospitalizations for injuries constitute the most serious categories of non-fatal unintentional injuries. The objective of this study was to examine the feasibility of using extant VHA administrative datasets to develop a VHA national Injury Surveillance System. Methods: Selected variables from all of the VHA hospital inpatient discharge datasets for five fiscal years (1998 through 2002) were extracted from the centralized VHA data repository at the Austin Automation Center. This produced a discharge dataset with over 3.4 million records. The selected variables extracted included demographic information, ICD-9-CM coded diagnoses, information on procedures and surgeries, and discharge status. The direct medical care costs for these five fiscal years of discharges was extracted from the Decision Support System (DSS) data at the Austin Automation Center. Results: Over the study time frame, 149,161 injury discharges occurred in the VHA system. Over 1.7 million inpatient days were associated with these discharges. Over $1.8 billion in direct medical care costs (unadjusted for inflation) were incurred by the VHA for these patients. On average, injury discharges accounted for 6% of total VHA medical costs, 5% of the total discharges, and 3% of the total patient hospital days. Implications: The feasibility of using extant VHA administrative datasets to monitor trends in the incidence and costs of veterans’ hospitalizations for injuries has been demonstrated. The information gained from an ISS has the potential to impact the organization of Veteran’s healthcare to positively impact patient safety and injury prevention initiatives.

Learning Objectives:

• List the five major features of the public health approach to injury prevention and how they are integrated in an injury surveillance system.
• Address the major data issues associated with ICD-9-CM E-codes within an injury surveillance system.
• Articulate the data issues associated with cost identification in injury surveillance systems.

Keywords: Injuries, Veterans

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.