评估医院出院记录作为严重工伤监测工具的作用。
An evaluation of hospital discharge records as a tool for serious work related injury surveillance.
作者信息
Alamgir H, Koehoorn M, Ostry A, Tompa E, Demers P
机构信息
Department of Health Care & Epidemiology, University of British Columbia, Vancouver, BC, Canada.
出版信息
Occup Environ Med. 2006 Apr;63(4):290-6. doi: 10.1136/oem.2005.026047.
OBJECTIVES
To identify and describe work related serious injuries among sawmill workers in British Columbia, Canada using hospital discharge records, and compare the agreement and capturing patterns of the work related indicators available in the hospital discharge records.
METHODS
Hospital discharge records were extracted from 1989 to 1998 for a cohort of sawmill workers. Work related injuries were identified from these records using International Classification of Disease (ICD-9) external cause of injury codes, which have a fifth digit, and sometimes a fourth digit, indicating place of occurrence, and the responsibility of payment schedule, which identifies workers' compensation as being responsible for payment.
RESULTS
The most frequent causes of work related hospitalisations were falls, machinery related, overexertion, struck against, cutting or piercing, and struck by falling objects. Almost all cases of machinery related, struck by falling object, and caught in or between injuries were found to be work related. Overall, there was good agreement between the two indicators (ICD-9 code and payment schedule) for identifying work relatedness of injury hospitalisations (kappa = 0.75, p < 0.01). There was better concordance between them for injuries, such as struck against, drowning/suffocation/foreign body, fire/flame/natural/environmental, and explosions/firearms/hot substance/electric current/radiation, and poor concordance for injuries, such as machinery related, struck by falling object, overexertion, cutting or piercing, and caught in or between.
CONCLUSIONS
Hospital discharge records are collected for administrative reasons, and thus are readily available. Depending on the coding reliability and validity, hospital discharge records represent an alternative and independent source of information for serious work related injuries. The study findings support the use of hospital discharge records as a potential surveillance system for such injuries.
目的
利用医院出院记录识别并描述加拿大不列颠哥伦比亚省锯木厂工人中与工作相关的重伤情况，并比较医院出院记录中可用的与工作相关指标的一致性和记录模式。
方法
提取了1989年至1998年一组锯木厂工人的医院出院记录。利用国际疾病分类（ICD - 9）损伤外部原因编码从这些记录中识别与工作相关的损伤，该编码有第五位数字，有时还有第四位数字，用于表明发生地点，以及支付计划责任，该责任确定工人赔偿负责支付。
结果
与工作相关的住院最常见原因是跌倒、与机器相关、过度劳累、碰撞、切割或穿刺以及被坠落物击中。几乎所有与机器相关、被坠落物击中以及卷入或夹在中间受伤的病例都被认定与工作相关。总体而言，在确定损伤住院与工作的相关性方面，两个指标（ICD - 9编码和支付计划）之间有良好的一致性（kappa = 0.75，p < 0.01）。对于碰撞、溺水/窒息/异物、火灾/火焰/自然/环境以及爆炸/火器/热物质/电流/辐射等损伤，它们之间的一致性较好；而对于与机器相关、被坠落物击中、过度劳累、切割或穿刺以及卷入或夹在中间等损伤，一致性较差。
结论
医院出院记录是出于行政原因收集的，因此很容易获取。根据编码的可靠性和有效性，医院出院记录是与工作相关重伤的另一种独立信息来源。研究结果支持将医院出院记录用作此类损伤的潜在监测系统。
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