Hospitalizations from injuries : a report on the completeness of external-cause-of-injury coding in North Carolina's hospital discharge data

SC HS Studies A Special Report Series by the State Center for Health Statistics 1908 Mail Service Center, Raleigh, N.C. 27699-1908 North Carolina Public Health WWW.SChs.State.nc.US/SCHS/ No. 128 December 2001 Hospitalizations from Injuries: A Report on the Completeness of External-Cause-of-Injury Coding in the State’s Hospital Discharge Data North Carolina, 1997-1999 by Catherine P. Sanford, MSPH1 Katrina R. Baggett, MAMS2 J. Michael Bowling, PhD3 ABSTRACT Objectives: The purpose of this study is to assess the completeness of the recording of external cause of injury codes (E-codes) on North Carolina hospital discharge records, for those patients with an injury as the primary cause of admission. E-codes are very important for public health efforts to identify the causes of in¬ juries and design programs to prevent injuries. Methods: North Carolina hospital discharge records for 1997 through 1999 with a primary diagnosis of in¬ jury were examined to determine the frequency of E-coding by the specific type of injury, age, race, gender, length of stay, payer classification, and level of trauma center. Results: Overall, from 1997 through 1999, 83 percent of North Carolina hospital discharge records with a primary diagnosis of injury had an E-code recorded. For most of the major categories of injury, the recording of E-codes was 95 percent or higher. There was little difference in E-coding by age, race, or gender. Patients with shorter lengths of stay had a higher rate of E-coding. Patients with Medicare as the main source of pay¬ ment had a relatively low rate of E-coding. Hospitals with the highest level of trauma center designation had the lowest rate of E-coding. Conclusions: Recording of E-codes for hospitalizations due to injury is generally high, especially consider¬ ing that the reporting of E-codes on hospital discharge records is voluntary in North Carolina. Greater aware¬ ness of the importance of E-codes might encourage hospitals to continue and to improve the reporting of E- codes for injury-related hospitalizations, which would enhance our ability to design effective injury preven¬ tion programs. 1 N.C. Department of Health and Human Services, Division of Public Health. Injury and Violence Prevention Unit. Raleigh. NC 2 N.C. Department of Health and Human Services, State Center for Health Statistics, Statistical Services Unit. Raleigh, NC 3 University of North Carolina Injury Prevention Research Center. Chapel Hill, NC NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES