Completeness of cause of injury coding in healthcare administrative databases in the United States, 2001.
OBJECTIVE
To determine the completeness of external cause of injury coding (E-coding) within healthcare administrative databases in the United States and to identify factors that contribute to variations in E-code reporting across states.


METHODS
Cross sectional analysis of the 2001 Healthcare Cost and Utilization Project (HCUP), including 33 State Inpatient Databases (SID), a Nationwide Inpatient Sample (NIS), and nine State Emergency Department Databases (SEDD). To assess state reporting practices, structured telephone interviews were conducted with the data organizations that participate in HCUP.


RESULTS
The percent of injury records with an injury E-code was 86% in HCUP's nationally representative database, the NIS. For the 33 states represented in the SID, completeness averaged 87%, with more than half of the states reporting E-codes on at least 90% of injuries. In the nine states also represented in the SEDD, completeness averaged 93%. Twenty two states had mandates for E-code reporting, but only eight had provisions for enforcing the mandates. These eight states had the highest rates of E-code completeness.


CONCLUSIONS
E-code reporting in administrative databases is relatively complete, but there is significant variation in completeness across the states. States with mandates for the collection of E-codes and with a mechanism to enforce those mandates had the highest rates of E-code reporting. Nine statewide ED data systems demonstrate consistently high E-coding completeness.
Coben
J H
JH
Injury Control Research Center, West Virginia University, Morgantown, WV, USA. jcoben@hsc.wvu.edu
Steiner
C A
CA
Barrett
M
M
Merrill
C T
CT
Adamson
D
D
D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005568:Forms and Records Control / Q000592:standards; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008500:Medical Records Department, Hospital / Q000592:standards*; D016347:Medical Records Systems, Computerized / Q000145:classification / Q000592:standards*; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000145:classification* / Q000453:epidemiology / Q000209:etiology