• Utilize the “Participants Summary Presentation” (see template) to illustrate value of data. • Inform students that next 2 days will focus on Injury Data, with three major blocks of instruction: 1. Review and morbidity/mortality coding (“Injury Data Introduction”) 2. Data Collection (“Data Collection”; “Data Collection Planning”; “Data Collection Lab”) 3. Basic Injury Epidemiology & Statistics (“Data Analysis”; “WISQARS”) Introduction to Data Presentation Billings Area 2011: Injury Data Introduction 1
Session goal & Objectives : (“By the end of the session, participants will be able to…) •Describe the uses of data including understanding an injury problem, guiding injury prevention programming, and uses in evaluation •Define the term “injury” as used in data collection—we will introduce a systematic method of classifying injury, the ICD •Define the types of data. We’ll include a review of some data terms we used in Introduction to IP, as well as a few new terms •List general sources of data Introduction to Data Presentation Billings Area 2011: Injury Data Introduction 2
Open Floor Discussion (ask the questions to the students; engage them to provide personal experiences; consider using flip chart to facilitate discussion) Two Types of Data: • Qualitative data: used to understand people’s opinions/attitudes/beliefs; collected through interviews, surveys, focus groups; gives insight on development of your program/messages/materials. • Quantitative data: raw numbers/counts; used indentify injury patterns. Collected through surveillance, observations, risk assessments; gives insight on setting program priorities and evaluating impact of your program. Use of Data in IP: •Understand trends/patterns/risk factors/causes of injury in a population •Set priorities for prevention •Guide/persuade decision makers re: public health policy (i.e., community survey data re: passing a seat belt law) •Develop program messages & materials (design of float coats in AK; safety message for a targeted group) •Justify needs/build your case for funding (i.e., grants) •Evaluate your program What are some common sources of injury data? •Local IHS Severe Injury Surveillance System (SISS) •Resource and Patient Management System (RPMS) •Medical Records & Death Certificates •EMS & Police •Observations (i.e., seat belt surveys, home safety assessments) •Questionnaires/Surveys/Focus Groups/Key Informant Interviews Introduction to Data Presentation Billings Area 2011: Injury Data Introduction 3
Two Types of Data: • Qualitative data: used to understand people’s opinions/attitudes/beliefs; collected through interviews, surveys, focus groups; gives insight on development of your program/messages/materials. • Quantitative data: raw numbers/counts; used indentify injury patterns. Collected through surveillance, observations, risk assessments; gives insight on setting program priorities and evaluating impact of your program. Use of Data in IP: •Understand trends/patterns/risk factors/causes of injury in a population •Set priorities for prevention •Guide/persuade decision makers re: public health policy (i.e., community survey data re: passing a seat belt law) •Develop program messages & materials (design of float coats in AK; safety message for a targeted group) •Justify needs/build your case for funding (i.e., grants) •Evaluate your program What are some common sources of injury data? •Local IHS Severe Injury Surveillance System (SISS) •Resource and Patient Management System (RPMS) •Medical Records & Death Certificates •EMS & Police •Observations (i.e., seat belt surveys, home safety assessments) •Questionnaires/Surveys/Focus Groups/Key Informant Interviews Introduction to Data Presentation Billings Area 2011: Injury Data Introduction 4
Introduction to Data Presentation Billings Area 2011: Injury Data Introduction 5
Introduction to Data Presentation Billings Area 2011: Injury Data Introduction 6
Agents of Injury: (Remember from Level 1, the epi triangle, with host, agent, and environment?) Injuries, for the most part, result from short-term exposure to large concentrations of energy: •Mechanical: crushing injury in wringer washer, energy transferred during M/V crash •Thermal: heat injuries—fire, hot water scalding •Chemical: battery acid spill, poisoning •Electrical: lightening •Radiation: sunburn, overexposure to x-ray •Absence of oxygen: drowning, suffocation, smoke inhalation, carbon monoxide •Absence of heat: hypothermia, frostbite •Excess heat: heat stroke (hyperthermia) Two Main Injury Categories: (An “agents of injury” isn’t a very specific way to categorize injuries for data collection and analysis) •Unintentional: Drowning, Fall, Fire/Burn, MVC, Poisoning, Other •Intentional: Suicide, Self-Harm, Assault (child abuse, elder abuse, domestic violence, etc) Note to Instructor: •Transition from two main categories of injury to ICD-9 •Consider statement similar to: “…In the medical field, injuries are classified with a standardized coding system call the International Classification of Disease…” Introduction to Data Presentation Billings Area 2011: Injury Data Introduction 7
Agents of Injury: (Remember from Level 1, the epi triangle, with host, agent, and environment?) Injuries, for the most part, result from short-term exposure to large concentrations of energy: •Mechanical: crushing injury in wringer washer, energy transferred during M/V crash •Thermal: heat injuries—fire, hot water scalding •Chemical: battery acid spill, poisoning •Electrical: lightening •Radiation: sunburn, overexposure to x-ray •Absence of oxygen: drowning, suffocation, smoke inhalation, carbon monoxide •Absence of heat: hypothermia, frostbite •Excess heat: heat stroke (hyperthermia Introduction to Data Presentation Billings Area 2011: Injury Data Introduction 8
Two Main Injury Categories: (An “agents of injury” isn’t a very specific way to categorize injuries for data collection and analysis) •Unintentional: Drowning, Fall, Fire/Burn, MVC, Poisoning, Other •Intentional: Suicide, Self-Harm, Assault (child abuse, elder abuse, domestic violence, etc) Introduction to Data Presentation Billings Area 2011: Injury Data Introduction 9
Note to Instructor: •There are several very good online resources for ICD-9 (some are include on a PPT slide at the end of this presentation) •The World Health Organization (WHO) is a very good resource: http://www.who.int/classifications/icd/en/ and includes a good “history lesson” at http://www.who.int/classifications/icd/en/HistoryOfICD.pdf. •The American Academy of Professional Coders (AAPC) is another good resource: http://www.aapc.com/. Go to the “resources” tab for ICD-10 and ICD-9 info. Of particular interest is the “code translator.” •The purpose of this presentation is not to make students expert, certified coders; instead we’re providing a general overview for students to have a good understanding of how injury is classified, how to query an existing database with ICD codes, and how to conduct a simple analysis of such a database. International Classification of Disease (general history & description): •History of ICD dates back to the 1850s (again, see WHO website for more on history) •Since 1948, World Health Organization (oversees the ICD •ICD is the international standard diagnostic classification system for all general epidemiological, many health management purposes and clinical use (including billing). •ICD includes codes for diagnosis of disease and injury; and cause of injury codes •Codes are updated annually; so it’s important to understand that new codes will influence multi-year analysis (example: Fall from skateboard introduced in year 3 of a 5 year dataset…if you didn’t know that was a new code, you would misinterpret that skateboard fall injuries didn’t start until yr3). •Since 1999 the United States has utilized two ICD versions: • ICD-9: Used to code non-fatal (i.e., doctor’s office visits and hospitalizations) • ICD-10: Used to code deaths •The two versions don’t directly correlate. One reason is that ICD-10 expands to 141,000 codes compared to ICD-9’s 17,000 Introduction to Data Presentation Billings Area 2011: Injury Data Introduction 10
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