Newmyer Ashley

Motor vehicle crashes (MVC) are a significant public health problem in Nebraska. These events cost Nebraska $1.6 billion a year, are the leading cause of injury death, and the fourth leading cause of injury hospital treatment in the state. Speeding, driving under the influence, distracted driving, and adverse weather are the main causes of MVC in Nebraska. Effective prevention efforts to reduce MVC related deaths and injuries depend greatly on a surveillance system that monitors the frequency of these events so stakeholders may ascertain the MVC related causes and impact on the state. Currently, the Nebraska Department of Health and Human Services (NDHHS) Crash Outcome Data Evaluation System (CODES) monitors MVC related death and injuries by linking the following databases statewide crash data, hospital discharge data (HDD), trauma registry, emergency medical system (EMS) data and death certificate data. Although this system has been effective in identifying the causes of MVC-ralated injuries and supporting community based highway safety programs, it is limited by the lack of immediate availability of data. ‘An ED based SS system could potentially be used to enhance MVC injury surveillance by allowing the timely detection of clusters, anomalies and trends. Therefore, and ED SS system could be incorporated to support an efficient and rapid prevention response to MVC-related injuries.

Objective

The objective of this pilot study is to demonstrate the value of emergency department (ED) syndromic surveillance (SS) data to aid the surveillance of motor vehicle crash (MVC) related injuries in Nebraska.

Achieving health equality is a national priority. The surveillance of health disparities in minority populations is key for the advancement of health equality. However, the need for improvement in documentation of race and ethnicity has been identified across various public health data sets. Currently, due to the lack of reporting of race and ethnicity in HDD, the NDHHS mainly depends on analyses of the statewide Behavioral Risk Factor Surveillance System and Vital Records data for the surveillance of health disparities among minority populations. An alternative data set that might help inform the surveillance of health disparities is SyS data. This near-real–time electronic health record data is characterized by required core data elements that provide information about the date and time of patient encounter, treating facility, clinical information, and patient demographics. Previously, we demonstrated statistically significant correlations between the 2011 and 2012 NDHHS ED SyS and ED HDD data for ICD9-CM ECODES corresponding to motor vehicle crash related injury, which is a relevant cause of health disparities. Our new objective was to determine the reporting consistency of ICD9-CM ECODES associated with other injury related health disparities between 2013 NDHHS SyS and HDD ED data. We also sought to determine if near-real–time ED and IP SyS data provide a more complete documentation of race and ethnicity than HDD.

Objective

This pilot study evaluates Nebraska Department of Health and Human Services (NDHHS) emergency department (ED) syndromic surveillance (SyS) data quality by cross-validating reported external cause of injury codes (ECODES) associated to racial/ethnic injury health disparities in Nebraska. The percent completeness of core data elements in SyS data and hospital discharge data (HDD) was also determined.