Sullivan M, Grossman D C
Department of Pediatrics, University of Washington, Seattle, USA.
Am J Prev Med. 1999 Jul;17(1):38-42. doi: 10.1016/s0749-3797(99)00034-3.
Little is known about the epidemiology of hospitalization for motor vehicle injury among American Indians and Alaska Natives (AI/ANs) in the Pacific Northwest. Current secondary data sources are inadequate to track this significant health problem. The purpose of this study was to determine the rate of hospitalization for motor vehicle injury in this population through linkage of Indian Health Service (IHS) patient registration data to a statewide hospital discharge database.
To create the numerator, IHS patient registration data were linked to Washington State hospital discharge abstracts from 1990 to 1994 for motor vehicle injury (ICD-9 E-codes 810-819). The denominator for this population was derived from the total number of IHS enrollees in 1992. Comparative numerator and denominator data for all residents were derived from the discharge database and Washington State intercensal population estimates, respectively.
AI/ANs experienced a nearly two-fold higher rate of motor vehicle injury hospitalization (N = 588) compared to all residents [Incidence Ratio (I.R.): 1.82; 95% C.I. 1.52-2.19]. The greatest disparity in incidence rates occurred among 25-34 year olds (I.R. 2.18; 95% C.I. 1.53-3.10) and 35-44 year olds (I.R. 2.18; 95% C.I. 1.36-3.47). In-hospital mortality, severity of injury and length of stay were not different between the 2 groups. Median charges for American Indian hospitalizations were $6188 and the IHS was payer in, at most, 24% of hospitalizations.
AI/ANs are at higher risk of hospitalization for motor vehicle injuries but, compared to all residents of Washington, appear to have similar severity of injuries and outcomes. Motor vehicle injury hospitalization among AI/ANs incurs substantial health care costs.
关于太平洋西北地区美国印第安人和阿拉斯加原住民（AI/ANs）因机动车伤害住院的流行病学情况，人们了解甚少。目前的二手数据来源不足以追踪这一重大健康问题。本研究的目的是通过将印第安卫生服务局（IHS）患者登记数据与全州范围的医院出院数据库相链接，来确定该人群中因机动车伤害住院的比率。
为得出分子数据，将IHS患者登记数据与1990年至1994年华盛顿州医院出院摘要中关于机动车伤害（国际疾病分类第九版E编码810 - 819）的数据相链接。该人群的分母来自1992年IHS参保者总数。所有居民的比较性分子和分母数据分别来自出院数据库和华盛顿州两次人口普查间的人口估计数。
与所有居民相比，AI/ANs因机动车伤害住院的比率（N = 588）高出近两倍[发病率比（I.R.）：1.82；95%置信区间1.52 - 2.19]。发病率差异最大的是25 - 34岁人群（I.R. 2.18；95%置信区间1.53 - 3.10）和35 - 44岁人群（I.R. 2.18；95%置信区间1.36 - 3.47）。两组的院内死亡率、伤害严重程度和住院时间并无差异。美国印第安人住院的中位费用为6188美元，且IHS最多支付24%的住院费用。
AI/ANs因机动车伤害住院的风险更高，但与华盛顿州所有居民相比，其伤害严重程度和结果似乎相似。AI/ANs因机动车伤害住院会产生大量医疗费用。
