Langley J, Stephenson S, Cryer C, Borman B
Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Inj Prev. 2002 Dec;8(4):332-7. doi: 10.1136/ip.8.4.332.
Injuries resulting in admission to hospital provide an important basis for determining priorities, emerging issues, and trends in injury. There are, however, a number of important issues to be considered in estimating person based injury incidence using such data. Failure to consider these could result in significant overestimates of incidence and incorrect conclusions about trends.
To demonstrate the degree to which estimates of the incidence of person based injury requiring hospital inpatient treatment vary depending on how one operationally defines an injury, and whether or not day patients, readmissions, and injury due to medical procedures are included.
The source of data for this study was New Zealand's National Minimum Dataset. The primary analyses were of a dataset of all 1989-98 discharges from public hospital who had an external cause of injury and poisoning code assigned to them.
The results show that estimates of the incidence of person based injury vary significantly depending on how one operationally defines an injury, and whether day patients, readmissions, and injury due to medical procedures are included. Moreover the effects vary significantly by pathology and over time.
(1) Those using New Zealand hospital discharge data for determining the incidence of injury should: (a) select cases which meet the following criteria: principal diagnosis injury only cases, patients with day stay of one day or more, and first admissions only, (b) note in their reporting that the measure is an estimate and could be as high as a 3% overestimate. (2) Other countries with similar data should investigate the merit of adopting a similar approach. (3) That the International Collaborative Effort on Injury Statistics review all diagnoses within International Classification of Diseases 9th and 10th revisions with a view to reaching consensus on an operational definition of an injury.
因伤住院为确定伤害的优先事项、新出现的问题和趋势提供了重要依据。然而，在使用此类数据估计基于人群的伤害发生率时，有一些重要问题需要考虑。如果不考虑这些问题，可能会导致对发生率的严重高估以及对趋势得出错误结论。
证明基于人群的需要住院治疗的伤害发生率估计值如何因伤害的操作定义方式以及是否纳入日间患者、再入院患者和医疗程序导致的伤害而有所不同。
本研究的数据来源是新西兰国家最低数据集。主要分析的数据集是1989 - 1998年所有从公立医院出院且被分配了外部伤害和中毒代码的患者。
结果表明，基于人群的伤害发生率估计值因伤害的操作定义方式以及是否纳入日间患者、再入院患者和医疗程序导致的伤害而有显著差异。此外，这些影响因病理类型和时间而有显著不同。
（1）那些使用新西兰医院出院数据来确定伤害发生率的人应：（a）选择符合以下标准的病例：仅主要诊断为伤害的病例、住院一天或以上的患者以及仅首次入院的患者，（b）在报告中注明该测量值是一个估计值，可能高估高达3%。（2）拥有类似数据的其他国家应研究采用类似方法的价值。（3）伤害统计国际协作组织应审查国际疾病分类第9版和第10版中的所有诊断，以期就伤害的操作定义达成共识。
