Analysis and Reporting of Injury-Related Inpatient Hospitalizations - - PowerPoint PPT Presentation

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Analysis and Reporting of Injury-Related Inpatient Hospitalizations - - PowerPoint PPT Presentation

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2017 CSTE Annual Conference Analysis and Reporting of Injury-Related Inpatient Hospitalizations Using ICD-10-CM-coded Administrative Billing Data Svetla Slavova, PhD Kentucky Injury Prevention and Research Center (KIPRC) KIPRC is a bona fide

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KIPRC is a bona fide agent for the Kentucky Department for Public Health, Cabinet for Health and Family Services

Analysis and Reporting of Injury-Related Inpatient Hospitalizations Using ICD-10-CM-coded Administrative Billing Data

Svetla Slavova, PhD Kentucky Injury Prevention and Research Center (KIPRC)

2017 CSTE Annual Conference

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Available from: https://www.cdc.gov/injury/stateprograms/indicators.html

Injury Hospitalization Subset of an ICD-9-CM-coded State Hospital Discharge Data (HDD) Set

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Injury Hospitalization Subset of an ICD-10-CM-coded State Hospital Discharge Data (HDD) Set

  • a. Identify injury records by searching the principal diagnosis field for any of the ICD-10-CM codes in the CDC case

selection criteria for injury hospitalizations (Table 5):

  • b. From the injury records, identify the subset of records that indicate an initial or subsequent encounter for

treatment of an injury.

Reference:

  • ISW9. (2016). injury Surveillance Workgroup 9. The Transition from ICD-9-CM to ICD-10-CM: Guidance for analysis and reporting of

injuries by mechanism and intent. . Retrieved from Atlanta, GA. Available from http://www.safestates.org/?page=ISWReports

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

5,936 6,655 6,790 6,117 5,938 6,435 6,876 6,768 6,313 6,974 7,303 6,851

1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000

2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Number of injury cases

Injury-Related Inpatient Hospitalizations in Kentucky Acute Care Hospitals, by Quarter, 2014 -2016

Total

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

90.8% 91.0% 90.9% 91.7% 91.8% 93.2% 93.2% 88.7% 91.6% 93.0% 91.9% 93.2% 86% 87% 88% 89% 90% 91% 92% 93% 94%

2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Number of injury cases

Percentage of Injury Hospitalizations with Valid External Cause of Injury Codes

% Injury Cases with a Cause of Injury (Based on Available Ecode)

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1Wagner AK, Soumerai SB, Zhang F, Ross‐Degnan D. Segmented regression analysis of interrupted time series studies in

medication use research. J Clin Pharm Therap 2002; 27(4), 299-309. Estimated changes in level and trend through segmented regression1 Perc_injury-records_with_external_cause_code t= β0 + β1*timet + β2*interventiont + β3*time-after-interventiont+ et,

Percentage of Injury Hospitalizations with Valid External Cause of Injury Codes

proc autoreg data=inputdataset outest=outputdataset; model perc_ecode_compl=time interv timeafter/method=ml dwprob; run;

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1Wagner AK, Soumerai SB, Zhang F, Ross‐Degnan D. Segmented regression analysis of interrupted time series studies in

medication use research. J Clin Pharm Therap 2002; 27(4), 299-309.

y = 0.4395x + 93.129 y = 0.936x + 88.882 75.0 77.0 79.0 81.0 83.0 85.0 87.0 89.0 91.0 93.0 95.0

  • 8
  • 6
  • 4
  • 2

2 4 6

Percentage of Injury Hospitalizations with Valid External Cause of Injury Code

Estimated changes in level and trend through segmented regression1 Perc_injury-records_with_external_cause_code t= β0 + β1*timet + β2*interventiont + β3*time-after-interventiont+ et, Parameter Estimates Variable DF Estimate

  • St. t Value

Approx Error Pr > |t| Intercept 1 93.129 0.5455 170.71 <.0001 Time 1 0.4395 0.1513 2.9 0.0198 Intervention 1

  • 3.7502

0.9179

  • 4.09

0.0035 Time-after- intervention 1 0.4965 0.295 1.68 0.1308

Percentage of Injury Hospitalizations with Valid External Cause of Injury Codes

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

Injury Hospitalizations by Intent, Kentucky, 2014 - 2016

0% 2% 4% 6% 8% 10% 12% 14% 16% 18% 20% INTENTIONAL SELF-HARM ASSAULT UNDETERMINED 80% 81% 82% 83% 84% 85% 86% 87% 88% 89% 90%

Number of injury cases

UNINTENTIONAL

2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

UNINTENTIONAL 85% 85% 84% 85% 84% 83% 84% 88% 88% 88% 88% 89% INTENTIONAL SELF- HARM 8% 8% 9% 9% 9% 9% 8% 9% 8% 9% 9% 8% ASSAULT 2% 3% 3% 2% 2% 3% 3% 2% 3% 3% 3% 3% UNDETERMINED 4% 4% 4% 4% 5% 5% 5% 1% 1% 1% 1% 1%

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

2,707 2,997 2,951 3,067 3,035 3,060 3,040 3,021 3,106 3,050 3,232 3,155 3,099 3,278 3,253 3,350 500 1000 1500 2000 2500 3000 3500 4000 2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Number of injury cases

Fall Injury Hospitalizations, Kentucky, 2013 - 2016

FALLS

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

71 59 74 95 67 83 75 74 77 119 77 77 79 114 106 110 20 40 60 80 100 120 140 2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Number of injury cases

Firearm Injury Hospitalizations, Kentucky, 2013 - 2016

FIREARM

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

41 65 116 46 87 87 110 50 59 76 111 38 64 85 123 51 20 40 60 80 100 120 140 2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Number of injury cases

Natural/Environmental Cause of Injury Hospitalizations, Kentucky, 2013 - 2016

NATURAL/ENVIR

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

1,040 1,176 1,225 1,053 1,024 1,137 1,172 1,078 1,056 1,197 1,312 1,223 1,203 1,265 1,289 1,158 200 400 600 800 1000 1200 1400 2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Number of injury cases

Poisoning Injury Hospitalizations, Kentucky, 2013 - 2016

POISONING

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

996 1,123 1,155 1,000 985 1,088 1,122 1,037 1,007 1,149 1,267 1,147 1,154 1,209 1,235 1,101 200 400 600 800 1,000 1,200 1,400 2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Number of injury cases

Kentucky Drug Poisoning Hospitalizations, 2013 - 2016

DRUG POISONING (injury data set)

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

200 400 600 800 1,000 1,200 1,400 1,600 1,800 2,000 2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Number of injury cases

Kentucky Drug Poisoning Hospitalizations, 2013 - 2016

DRUG POISONING (injury data set) DRUG POISONING (any diagnosis or external cause code)

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

747 471 1,171 866 658 1,067 1,141 856 685 945 1,055 931 753 1,096 1,277 1,086 200 400 600 800 1000 1200 1400

2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Number of injury cases

Injury Hospitalizations with “All Transportation” Mechanism, Kentucky, 2013 - 2016

ALL TRANSPORTATION

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

648 327 902 744 568 820 904 715 610 710 842 700 573 791 954 865 200 400 600 800 1000 1200 2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Number of injury cases

Motor Vehicle Traffic Injury Hospitalizations, Kentucky, 2013 - 2016

MVTC

Proposed ICD-10-CM external cause matrix Motor Vehicle-Traffic (MVT) MVT-Occupant MVT-Motorcyclist MVT-Pedal cyclist MVT-Pedestrian MVT-Other* MVT-Unspecified

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

5 10 15 20 25 30 35 40 45 2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Number of injury cases

Kentucky Injury Hospitalizations with Mechanism “Other Pedestrian”, 2013- 2016

OTHER PEDESTRIAN

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

81 120 208 107 75 180 193 111 64 197 171 181 149 260 276 186 50 100 150 200 250 300 2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Number of injury cases

Kentucky Injury Hospitalizations with Mechanism of Injury “Other Transportation”, 2013 - 2016

OTHER TRANS

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

16 14 12 17 14 19 20 19 9 16 15 30 26 25 28 24 5 10 15 20 25 30 35 2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Number of injury cases

Suffocation Injury Hospitalizations in Kentucky, 2013- 2016

SUFFOCATION

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

10 20 30 40 50 60 2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Number of injury cases

Overexertion Injury Hospitalizations, Kentucky, 2013 - 2016

OVEREXERTION

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

5 25 45 65 85 105

Number of injury cases

Kentucky Injury Hospitalizations with Mechanism “Other Specified”, 2013 -2016

Other Speficied and Classifiable OTHER SPECIFIED,CHILD/ADULT ABUSE OTHER SPECIFIED,FOREIGN BODY OTHER SPECIFIED,CLASSIFIABLE OTHER SPECIFIED,NOT ELSEWHERE CLASSIFIABLE Other Specified, Not Elsewhere Classifiable

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

63 57 99 81 82 70 85 67 56 77 88 56 77 76 69 70 20 40 60 80 100 120 2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Number of Injury Cases

Injury Hospitalizations with “Other Specified” Mechanism, Kentucky, 2013 - 2016

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

75 84 66 91 70 80 90 85 75 90 119 140 125 124 154 124 20 40 60 80 100 120 140 160 180 2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Number of injury cases

Injury Hospitalizations with “Not Specified” Mechanism, Kentucky, 2013 - 2016

NOT SPECIFIED Not Specified ( X58 Exposure to Other Specified Factors)

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

32% 16% 32% 34% 35% 37% 35% 37% 41% 40% 40% 42% 41% 40% 39% 41% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Number of injury cases

Kentucky Injury Hospitalization Records with Place of Injury Codes, 2013 - 2016

Percentage injury records with a code for place of injury occurrence

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

3% 1% 2% 2% 3% 3% 3% 2% 2% 3% 3% 13% 12% 12% 12% 10% 0% 2% 4% 6% 8% 10% 12% 14% 2013Q1 2013Q2 2013Q3 2013Q4 2014Q1 2014Q2 2014Q3 2014Q4 2015Q1 2015Q2 2015Q3 2015Q4 2016Q1 2016Q2 2016Q3 2016Q4

Number of injury cases

Kentucky Injury Hospitalization Records with Codes for Activity, 2013 - 2016

Percentage injury records with a code for activity

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Hedegaard, H., Johnson, R. L., Warner, M., Chen, L. H., & Annest, J. L. (2016). Proposed Framework for Presenting Injury Data Using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) Diagnosis Codes. Natl Health Stat Report(89), 1-20. https://www.ncbi.nlm.nih.gov/pubmed/26828779

Traumatic Brain Injuries (TBI) Treated in Acute Care Hospitals

Thomas KE, Johnson RL. State injury indicators report: Instructions for Preparing 2015 Data. Atlanta (GA):Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2017. https://www.cdc.gov/injury/pdfs/2015_state_inj ury_indicator_instructions-a.pdf

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

Traumatic Brain Injuries (TBI) Treated in Kentucky Acute Care Hospitals, 2013 - 2016

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Produced by the Kentucky Injury Prevention and Research Center, a bona fide agent for the Kentucky Department for Public Health. May 2017. Data source: Kentucky Inpatient Claims, 2013-2016, Office of Health Policy, Cabinet for Health and Family Services. Data are provisional and subject to change.

54.1% 29.4% 4.3% 12.2% 50.4% 29.1% 5.2% 15.3% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% Fall MVT Struck by/against All other

Percentage of TBI Hospitalizations

TBI Hospitalizations in Kentucky, by Mechanism of Injury

2014 2016

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Svetla Slavova ssslav2@email.uky.edu

This presentation was supported by the Grant or Cooperative Agreement Number, 5 U17 CE002732-02, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.