Injury Prevention Research Unit, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Inj Prev. 2012 Aug;18(4):246-52. doi: 10.1136/injuryprev-2011-040081. Epub 2011 Nov 19.
To monitor accurately injury incidence trends, indicators should measure incidence independently of extraneous factors. Frequencies and rates of New Zealand's serious non-fatal self-harm indicators may be prone to fluctuations in reporting owing, for example, to changing social norms. Hence, they have been considered provisional.
To validate empirically the serious non-fatal self-harm indicators. Methods All serious non-fatal first admissions to hospital were identified and classified according to whether principal diagnosis (PDx) was injury or mental disorder, and conversely whether contributing diagnoses were mental disorder or injury. The proportion assigned self-harm external cause of injury code (E-code) was calculated for each year from 2001 to 2007. Subsequently, all cases with a self-harm E-code were identified, and the proportion with a PDx of injury and contributing diagnosis of mental disorder, or PDx of mental disorder and contributing diagnosis of injury over time, were determined.
No linear changes over time were detected in the proportion of cases assigned an injury PDx, or the proportion assigned a mental disorder PDx, or the proportion with a self-harm E-code. The estimated maximum observed increase in the frequency of serious non-fatal self-harm hospitalisation explained by changes in reporting was 19- 40%.
Identification of serious non-fatal self-harm events using an operational definition of PDx of injury, a self-harm first listed E-code, and an appropriate severity cut-off point, is a valid method of monitoring incidence and rates in New Zealand.
为了准确监测伤害发生率趋势，指标应独立于外部因素来衡量发生率。由于报告中不断变化的社会规范等原因，新西兰严重非致命性自伤指标的频率和比率可能容易出现波动，因此被认为是临时性的。
通过实证验证严重非致命性自伤指标。方法：根据主要诊断（PDx）是否为损伤或精神障碍，以及相反地，是否为精神障碍或损伤的促成诊断，确定所有严重非致命性首次住院的患者，并对其进行分类。计算 2001 年至 2007 年每年分配的伤害外部原因代码（E 代码）的比例。随后，确定所有具有自伤 E 代码的病例，并确定随着时间的推移，具有损伤 PDx 和精神障碍促成诊断或精神障碍 PDx 和损伤促成诊断的病例比例。
未发现分配损伤 PDx 的病例比例、分配精神障碍 PDx 的病例比例或具有自伤 E 代码的病例比例随时间线性变化。报告变化引起的严重非致命性自伤住院频率的最大观察到的估计增加幅度为 19-40%。
使用损伤 PDx 的操作定义、自伤第一个列出的 E 代码和适当的严重程度截断点识别严重非致命性自伤事件是监测新西兰发病率和比率的有效方法。
