Department of Public Health, Erasmus MC, Rotterdam, The Netherlands.
Int J Inj Contr Saf Promot. 2010 Mar;17(1):13-22. doi: 10.1080/17457300903523237.
The objective of this study was to assess whether the emergency department (ED) injury surveillance systems in Europe are suitable for cross-country comparisons. For this, the ED injury surveillance systems in Austria, Denmark, Greece, Ireland, the Netherlands, Norway and the UK (England, Wales) were considered. Standardised injury incidence and healthcare utilisation indices were calculated and the influence of measurement bias due to data collection and sampling differences, as well as trauma policy and health systems characteristics were assessed. The results showed that there was an over 3-fold variation of the grossly estimated incidence for home and leisure injuries (HLIs), with the highest values observed in England and Greece (111 and 104 per 1000 person years), and the lowest in Ireland and the Netherlands (27 and 48 per 1000 person years). The ranking of countries changed, however, when only injuries with an inherent need for ED treatment were considered (selected radiological verifiable fractures) with Austria topping the table followed by Greece and England. Thus, it is concluded that the naive use of ED injury surveillance systems for cross-country comparisons should be discouraged, as this is subject to measurement bias. Nevertheless, the observed variation in the healthcare utilisation and injury incidence, particularly among children and older people, indicates the potential to reduce the burden of HLI in Europe.
本研究旨在评估欧洲的急诊（ED）伤害监测系统是否适合跨国比较。为此，考虑了奥地利、丹麦、希腊、爱尔兰、荷兰、挪威和英国（英格兰、威尔士）的 ED 伤害监测系统。计算了标准化的伤害发生率和医疗保健利用指数，并评估了由于数据收集和抽样差异、创伤政策和卫生系统特征导致的测量偏差的影响。结果表明，家庭和休闲伤害（HLIs）的粗略估计发生率差异超过 3 倍，其中英格兰和希腊的发生率最高（每 1000 人年 111 和 104 例），爱尔兰和荷兰的发生率最低（每 1000 人年 27 和 48 例）。然而，当仅考虑需要 ED 治疗的伤害时（选择具有内在需要进行放射学验证的骨折），国家的排名发生了变化，奥地利位居榜首，其次是希腊和英格兰。因此，结论是，不鼓励盲目使用 ED 伤害监测系统进行跨国比较，因为这会受到测量偏差的影响。尽管如此，观察到的医疗保健利用和伤害发生率的差异，特别是在儿童和老年人中，表明有可能减轻欧洲 HLIs 的负担。
