The reliability of information on work-related injuries available from hospitalisation data in Australia.
OBJECTIVE
To examine the reliability of work-related activity coding for injury-related hospitalisations in Australia.


METHODS
A random sample of 4,373 injury-related hospital separations from 1 July 2002 to 30 June 2004 were obtained from a stratified random sample of 50 hospitals across four states in Australia. From this sample, cases were identified as work-related if they contained an ICD-10-AM work-related activity code (U73) allocated by either: (i) the original coder; (ii) an independent auditor, blinded to the original code; or (iii) a research assistant, blinded to both the original and auditor codes, who reviewed narrative text extracted from the medical record. The concordance of activity coding and number of cases identified as work-related using each method were compared.


RESULTS
Of the 4,373 cases sampled, 318 cases were identified as being work-related using any of the three methods for identification. The original coder identified 217 and the auditor identified 266 work-related cases (68.2% and 83.6% of the total cases identified, respectively). Around 10% of cases were only identified through the text description review. The original coder and auditor agreed on the assignment of work-relatedness for 68.9% of cases.


CONCLUSIONS
The best estimates of the frequency of hospital admissions for occupational injury underestimate the burden by around 32%. This is a substantial underestimate that has major implications for public policy, and highlights the need for further work on improving the quality and completeness of routine, administrative data sources for a more complete identification of work-related injuries.
McKenzie
Kirsten
K
National Centre for Classification in Health, School of Public Health, Queensland University of Technology, Australia. k.mckenzie@qut.edu.au
Mitchell
Rebecca
R
Scott
Deborah Anne
DA
Harrison
James Edward
JE
McClure
Roderick John
RJ
D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001315:Australia / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D017678:Sex Distribution; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult