Australian Injury Indicators - PowerPoint PPT Presentation

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Australian Injury Indicators

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Australian Injury Indicators James Harrison Malinda Steenkamp Research Centre for Injury Studies, Flinders University of South Australia Incorporating the AIHW ... – PowerPoint PPT presentation

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Title: Australian Injury Indicators


1
Australian Injury Indicators
  • James Harrison
  • Malinda Steenkamp
  • Research Centre for Injury Studies,
  • Flinders University of South Australia
  • Incorporating the AIHW National Injury
    Surveillance Unit

2
Background
  • Injury - National Health Priority Area
  • 34 Australian Injury Indicators
  • NISU report on injury indicators
  • Update data source developments
  • Provide technical review and specification of
    indicators
  • Identify actions and processes for further
    improvements

3
Australian Injury Indicators
  • 12 - deaths data
  • Death rate (DR) for injury in total population
  • DRRatio injury status of Indigenous
    non-Indigenous populations
  • 11 - morbidity data
  • Hospital separation rate (HSR) for falls -
    persons 65 yrs
  • HSR for near drowning - children 0-4 yrs
  • Rest - other data sources/not defined
  • domestic pools with appropriate
    barriers/fencing
  • Access of injury patients to optimal care

4
Useful and valid injury indicators?
  • Purposes and topics
  • Specifications
  • Data sources (not discussed)
  • Data quality (not discussed)

5
Purpose
  • Process - Purpose(s) of indicators?
  • Why specified purpose?
  • To guide development and evaluation
  • Information requirements
  • Current set - no specific purpose
  • Ambiguity in specification
  • e.g. indicators based on hospital data measuring
  • population incidence of serious injury?
  • burden of injury on acute health care services?
  • something else?

6
Australian Injury Indicators
  • Injury indicators based on national data
  • 12 based on deaths data
  • (e.g. Death rate for injury in total population)
  • 11 based on morbidity data
  • (e.g. Hospital separation rate for falls -
    persons 65 yrs)
  • Rest - other data sources/not defined
  • (Total number of Australian injury indicators34)

7
Purpose(s) of injury indicators
  • Indicators based on national data
  • To measure, and monitor change in, the population
    incidence of serious injury in Australia
    (recommended)
  • Remaining indicators
  • Purpose not clear (not discussed further)

8
Technical specifications (1)
  • Translates purpose and topic - set of definitions
    and instructions
  • Specification
  • Definition of a measure
  • Documenting definitions and instructions
  • Criteria ( after Injury ICE, Cryer, Langley, et
    al)
  • Define ito anatomical/physiological damage
  • Included cases should be all/well-defined sample
  • Case ascertainment independent

9
Technical specifications (2)
  • Defined ito anatomical/physiological damage?
  • NO, based on external cause codes
  • (e.g. Falls in 65 - ICD-9 E880-E888)
  • Reflects data situation at time of definition
  • Change in situation - deaths and hospital data
  • ? Redefine injury ito ICD-10(-AM) S00-T89
  • Includes Medical injury (T80-T88)
  • Excludes Sequelae (T90-98)

10
Technical specifications (3)
  • Included cases all/well defined sample?
  • National deaths data collection
  • All supposed to be includedNo formal
    evaluations
  • National Hospital Morbidity Data Base
  • Nearly all cases - small number excluded
  • No formal evaluations
  • Private hospital coverage - 94.4
  • Not all injuries - of various types not
    incl.?
  • (changes in admission policies, etc.)

11
Technical specifications (4)
  • Ascertainment independent?
  • National deaths data collection
  • In general - probably YES, some queries
  • Age-related variation in querying External cause
  • National Hospital Morbidity Data Base
  • Only some injuries result in admission
  • Some admitted cases - more than one record
  • Some injury occur in hospital
  • Deaths in hospital data

12
Draft Framework (1)
13
Draft Framework (2)
14
Two models of specification
  • Minimal change model
  • Better specification based on more comprehensive
    criteria - replicate explicit and implicit
    specifications that underlie indicators as
    originally specified
  • Technically revised model
  • Recommended revisions - now feasiblewill
    improve national data for purpose of monitoring
    population incidence of serious injury

15
Technically revised model
  • Specification - set of technical criteria
  • Restriction of cases with anatomical/physiological
    damage
  • Omitting same day cases from hospital data
  • Specifying mortality indicators ito date of death
  • Re-specification of all indicators ito ICD-10
    codes

16
Main points
  • Part of national process, for review and testing
  • Most indicators refer to injury occurrence
  • Purpose Measure and monitor change in population
    incidence of serious injury in Australia
  • Specific products
  • Better technical specification of current
    indicators based on more comprehensive criteria
    (Minimal change model)
  • Recommendations for improvements re monitoring
    population incidence of injury (Technically
    revised model)

17
Further development
  • Indicators of injury incidence
  • Implement Technically revised model after
    discussion and testing
  • Ensure enough system stability to enable
    monitoring
  • Implement incremental technical refinement
  • Develop indicators of severe injury incidence
  • Review indicator specification periodically
  • Undertake quality assurance
  • Propose changes to data sources where necessary
  • Remaining indicators
  • Assess and specify purpose(s)
  • Revise, develop, introduce relevant new ones
  • Develop new data sources where possible
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