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Data systems and injury surveillance

The Centre conducts a range of projects using various injury databases including describing epidemiological trends and examining methodological aspects of injury data systems.

1. Understanding road crash data better - factors that influence the likelihood of hospitalisation records matching police crash reports

Centre Investigators
Soufiane Boufous, Sanja Lujic (NSW Health Biostatistical Trainee), Caroline Finch, Andrew Hayen

William Dunsmuir (School of Mathematics, UNSW)

It has become increasingly common to link complementary data sources to enhance the value of motor transport injury databases. The aims of the project were to examine the extent to which a linkage of hospital discharge data with police crash records is useful for describing road crashes; to determine how well "true" matched cases are correctly linked; and to identify factors associated with an increased likelihood of being matched. Hospital separation records for the period 1 July 2000-30 June 2001, inclusive, were linked to police crash records for the same period using probabilistic record linkage techniques. Multivariate logistic regression techniques were used to identify factors independently associated with linkage rates. The most significant factors contributing to the likelihood of linkage were found to be occupant type (eg motor vehicle controllers), payment status (eg cases entitled to financial compensation) and principal diagnosis of injury variables. Interpretation of resultant road crash analyses of linked data need to take into account potential biases associated with differential matching rates across variables of interest.

2. Estimating the incidence of hospitalised injurious falls: Impact of varying case definitions

Centre Investigators
Soufiane Boufous, Caroline Finch

In the absence of unique personal identifiers in hospital admissions datasets, previous studies have used different approaches to identifying incident cases (first admissions) of hospitalised injurious falls. These approaches have included the exclusion of "readmission within 28 days" cases, "transfers" admissions to "non-acute hospitals" and "day only" admissions. The aim of this study was to examine the validity, as well as the impact, of different approaches on incidence estimates of hospitalised falls. When comparing the performance of different approaches to identifying first admissions, to that of the data linkage "gold standard", the "transfer from" variable performed best in identifying first admissions in terms of sensitivity and specificity. However, all the appraoches have relatively low specificity raising questions about their use. The introduction of a Unique Patient Identifier and the data of injury in hospital discharge datasets would provide a more accurate picture of incident cases of fall-related hospitalisations.

3. Record linkage: A tool for injury prevention research

Centre Investigators
Soufiane Boufous, Caroline Finch

Traditionally, much record linkage has focused on cancer research before being gradually applied to various areas of public health. Application of record linkage techniques to injury prevention research has only been a fairly recent development. The study assessed the importance of record linkage for injury research and reviewed previous applications in this area. It also examined some of the specific practical and privacy issues that present challengeds to the linkage of data for injury prevention and control Suggestions regarding steps that need to be taken to improve the quality and ease of undertaking data linkage for injury research were developed.

4. The triage injury surveillance project

Centre Investigators
Andrew Marich (NSW Public Health Officer Training Program), Caroline Finch

This project developed and trialled an injury surveillance system for use in hospital emergency departments. A particular focus was on the assessment of the utility of the routine collection of narrative by triage nurses in Emergency Departments. Feedback from the triage injury surveillance system was also fed back to the developers of NSW Health's Public Health Real-Time Emergency Department Surveillance System, to assist in its ongoing application in the injury setting.

5. Investigation of coronial data

Centre Investigators
Melissa Iriwin (NSW Public Health Officer Training Program), Andrew Hayen, Caroline Finch

Coronial data have the potential to provide a rich source of information about fatal injury. The aims of this project were to assess the usefulness of the National Coroners Information System, for contributing information to the epidemiological profile on injuries in the state, as well as more detailed information about mechanism of injury.

6. NSW injury hospitalisation profile

Centre Investigators
Andrew Hayen, Rebecca Mitchell

Almost all serious non-fatal injuries lead to hospitalisation. A review of injury hospitalisations of NSW residents in the period of 1989-1990 to 2003-04 was undertaken. The aims of this project were to examine the leading cause of injury hospitalisation and describe trends in hospitalised injury in NSW. Data analysis and writing of the report was conducted in 2005. The report was launched in 2006.

7. Public health and violence

Centre Investigators
Caroline Finch

Anthony Zwi (School of Public Health and Community Medicine, UNSW), Alison Rutherford (School of Public Health and Community Medicine, UNSW). The project was directed by Prof Zwi and his team at the School of Public Health and Community Medicine.

This project explored possibilities of linking work of population health with other sectors involved in the prevention, management and monitoring of violence and crime. In doing so, it described future initiatives aime at improving quality of health data and recommended a future work program for the NSW Health Injury Policy Branch. This involved mapping current actors, identifying data sources, trends and gaps; and identifying the role of the health sector in violence prevention. Twenty-two interviews were conducted with thirty-one key stakeholders in government and non-government organisations in the health, community, criminology, police and other sectors; nine custodians of routine data collections managed within NSW Health were also surveyed.







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