Using injury severity to improve occupational injury trend estimates.
Sears-JM; Bowman-SM; Hogg-Juhnson-S
Am J Ind Med 2014 Aug; 57(8):928-939
Background: Hospitalization-based estimates of trends in injury incidence are also affected by trends in health care practices and payer coverage that may differentially impact minor injuries. This study assessed whether implementing a severity threshold would improve occupational injury surveillance. Methods: Hospital discharge data from four states and a national survey were used to identify traumatic injuries (1998-2009). Negative binomial regression was used to model injury trends with/without severity restriction, and to test trend divergence by severity. Results: Trend estimates were generally biased downward in the absence of severity restriction, more so for occupational than non-occupational injuries. Restriction to severe injuries provided a markedly different overall picture of trends. Conclusions: Severity restriction may improve occupational injury trend estimates by reducing temporal biases such as increasingly restrictive hospital admission practices, constricting workers' compensation coverage, and decreasing identification/reporting of minor work-related injuries. Injury severity measures should be developed for occupational injury surveillance systems.
Injuries; Traumatic-injuries; Models; Injury-prevention; Preventive-medicine; Surveillance-programs; Workers; Work-environment;
Author Keywords: injury severity; abbreviated injury scale; injury trends; injury surveillance; occupational injuries; hospital discharge data; workers' compensation; occupational health indicator
Jeanne M. Sears, PhD, MS, RN, Department of Health Services, University of Washington, Box 354809, Seattle, WA 98195
American Journal of Industrial Medicine
University of Washington