ࡱ> ( / 00DArialngs8B(0(B 0 "DGaramond8B(0(B 0  DTimes New Roman(0(B 0 0DWingdingsRoman(0(B 0  A .  @n?" dd@  @@`` H@ XW|    < Y\RRHM*Z1 2345678S=>?@A?BC 0AA 3337Z3@8wB@ ʚ;~|K.ʚ;g4<d<d@B 0ppp@ <4ddddlpC 0B <4BdBdlhG 080___PPT10 ?  %O  =PDHospital separations selection of records for injury surveillance (E6-$6D 1Susan G. Mackenzie Public Health Agency of Canada1 ISelection of hospital separation records for analysis of external causes JH$(I tWhat differences are there between (and within) countries? Is there a generally preferred, or most common, approach?u;:t  ECompare results of Canadian and US approaches using the same data setFF(E  Data set All acute care separations from the province of Manitoba for 2000-01, excluding newborns and records with serious errors. N=126,217 Select all records where The tabulating diagnosis is an injury (in chapter 17 of ICD-9) or There is an external cause on the record N=14,772 x !   !  ;Exclude invalid diagnoses (chapter 17) and external causes<<$; Invalid diagnoses  only in the US Complications of care, adverse effects, allergic and anaphylactic reactions, others Injury Surveillance Workgroup. Consensus recommendations for using hospital discharge data for injury surveillance. Marietta (GA): State and Territorial Injury Prevention Directors Association; 2003. Invalid external causes  in Canada and the US Adverse effects Centers for Disease Control and Prevention. Recommended framework for presenting injury mortality data . MMWR 1997;46 (No. RR-14)#ZTZZZ/ZZZ#T  /    eDistribution of selected external cause groups using US and CA approaches data from Manitoba 2000-01fK e (NMost frequent groups of records kept only with the Canadian approach N=2,964OG$N  Summary( US selection based on Valid injury diagnoses and valid external causes Canadian selection based on Valid external causes Canadian approach yields more records There are quite large differences in the rates for some external cause groups Other countries? Z1ZZZ&ZNZZZZ1&N    Two approaches used in Canada Canadian Institute for Health Information Acute care No serious errors Adverse effects excluded Newborns included Other exclusions Poisoning, choking, late effects, travel & motion, hunger, thirst, exposure, neglect R*ZU*ZU(F   DPublic Health Agency of Canada Same Same Same Newborns excluded None(&&D 6Compare overall results of the two Canadian approaches77(6 /!%&') ` 3` ff>>\fg` J*T333` QYmx~3ft` \ғhEy`` cb^DDf`Y˵W` sg7xGr` K%ޯd{mG/` 33f>?" dd@,?nFd@    @ `  n?" dd@   @@``PR    @ ` `<p>> $(  $ $ 6V #" `b `  X*  $ 6R #" `` `  Z* xT ~ $ "~\ { $ "{ $ c BB CDEFd @ bb   H   T W6Vw}\gFQ6<1++11 1L b6xQrq 6\}N   - c    0 A Q g     S    6N KawF bFy0 a*ly7lE;uz  B | a F 0 ! 1 < B < & l L 0  @`"T  $ c |BC+DEFyd @ ==gL6cI}\eA& w6m!W<! &<W!r6W}F6\}>68QNlX^XH8+Sgg|@`"Jo 5 J $  B! 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CDEF @ ))\*l{FDNF W% W ! !   ! 6X L b x_ /aF6b}SA$|l\\TX@`s"*  T  u4 ( B C%DEF ss&QW}k6D Q r 8 N c t y y ;t Qi gS }8     T   :0\-Q4*%%v*o(V}5q;  S   < s } l \ g} \, L ;n &  Z}\[6 }WF<! e C }h m W ]  ,t B RxkqA,Rg@`" {b (  BCDEFy @ ,,Lh6\}mWG &a*zCxsh-&jG]~5g6&LLZ\@`s"*   u(   (  BCDE|Fy @ __@% M|f4@{ f0`lA}L\A+h MB6ww FJl{ 0V|{J  *5KlGn a*:Pf\|6 /6Kbf|F kP}5x}VvaP@@@`s"*   =>   ( c BlCrDEF"d@ rlrl@`"~  ( <l  "F    T Click to edit Master title style! !  ( 0X  " `     W#Click to edit Master subtitle style$ $  ( 6  #" `` `   X*  ( 6<  #" `b    Z*  ( 6  #" `d `   Z* B ( s *޽h ? 3___PPT10i. u%.+D=' = @B + 0 0*(    0X W%   X*   0D  %  Z* d  c $ ?0K    0   >)  RClick to edit Master text styles Second level Third level Fourth level Fifth level!     S  64 W   X*   6d    Z* H  0i ? 3380___PPT10.Lp d(  d  d NȰii W%   v* F##FFjj d Nii  %  x* F##FFjj d T\&ii W   v* F##FFjj d T8)ii    x* F##FFjjH d 0i ? 3380___PPT10.UKpck zP(  x  c $X5  (F  5  r  S (5  ( `   5    05 ` G 0Presented at ICE meeting in Cuernavaca June 20051 210 H  0޽h ? 33___PPT10i.FK@+D=' = @B +}  ,$(  ,r , S 5  $ `}  5  r , S 5 $ ` 5  H , 0޽h ? 3___PPT10i.GK`ߑ+D=' = @B +}  `$(  `r ` S $5  $ `}  5  r ` S 5 $ ` 5  H ` 0޽h ? 3___PPT10i.TK@v+D=' = @B +b  y q Xp (  pX p 00LB p c $D  p 6|5 o"`@@ @ LB p c $D  p 0T5 &  lExternal cause on record 2  p 0*5 <`  [Present 2  p 0@(5 < ] Not present     p 6p5  0  ICD-9 Diagnosis chapterH 2    p 6U5 <p j17- Injury & poisoning 2   p 65  <  YOther 2   p 0 W5 "` T14,772 2 LB p c $D  RB p s *Do @ RB p s *Do@p p  Rp 05    S0  Sp 05  P  p 4,499 (30%), 2   Tp 0;5 *) p 8,254 (56%), 2   Up 05 @ p 2,019 (14%), 2  H p 0޽h ? 33___PPT10i.8K+D=' = @B +}  $(  r  S `5  $ `}  5  r  S 45 $ ` 5  H  0޽h ? 3___PPT10i.Lh+D=' = @B + %[ti(  tX t 00LB t c $D  t 65 o"`@@ @ LB t c $D  t 05 &  lExternal cause on record 2  t 085 <`  [Present 2  t 0D5 < ] Not present     t 6G5 P0  ICD-9 Diagnosis chapterH 2    t 6h5 <p j17- Injury & poisoning 2   t 65  <  YOther 2   t 05  T14,772 2 LB  t c $D  RB t s *Do @ RB t s *Do@p p  t <5 0 Q0  t 0Џ5 "``  > LB t c $D LB t c $D` t 0#5   U7,785 2  t 05  "  S129 2  t 0e5 0p Q110 2  t 05 0"  O230  /t 0%@ p '  W8,254 2  0t 0 '@"'  W2,019 2  1t 0*0  W4,499 2  3t 0-  S7,785 2  4t 0L2   Q129 2  :t 0/.  u!None has a valid injury diagnosis"(2"!  ;t <d:@` WValid   YInvalid  @t <0= ` YInvalid  Ft 6LFb YValid 2  Gt 6@ bInjury diagnosis 2  Ht 0 N@ p '  W8,254 2  It 0Q@"'  W2,019 2  Yt 0KKB2 > 2 H t 0޽h ? 33___PPT10i.8K+D=' = @B +#! : 2 0Qx(  xX x 00LB x c $D  x 6]o"`@@ @ LB x c $D  x 0l`&  lExternal cause on record 2  x 0[<`  [Present 2  x 0b< ] Not present     x 680  kICD-9 Diagnosis chapter 2   x 64p<p j17- Injury & poisoning 2   x 6,t <  YOther 2   x 0w T14,772 2 LB  x c $D  RB x s *Do @ RB x s *Do@p p  x <t{0 Q0  x 0L"``  > LB x c $D LB x c $D` x 0  U7,785 2  x 0L "  S129 2  x 00p Q110 2  x 0(0"  O230  x 0Ȫ"`   : LB x c $D LB x c $D`  `  x 0,o   S2,050 2   x 0Ѝo @  S1,560 2  !x 0؏o f  O804  "x 0x 6o0 p ZV-code 2  ?x 04o` @  YInvalid  @x <o ` YInvalid  Fx 6ob YValid 2  Gx 6$o bInjury diagnosis 2  Hx 0$o@ p '  W8,254 2  Ix 0o@"'  W2,019 2  Qx 6Ho  eDiagnosis chapter 2 H x 0޽h ? 33___PPT10i.8K+D=' = @B +M& d%\%6Q|$(  |X | 00LB | c $D  | 6oo"`p@  @ LB | c $D  | 0`o&  hExternal cause on record 2  | 0o<`  WPresent 2  | 0o< Y Not present     | 6 oP0  ICD-9 Diagnosis chapterD 2    | 6&o<p f17- Injury & poisoning 2   | 64+o <  UOther 2   | 0t/o T14,772 2 LB  | c $D  RB | s *Do @ RB | s *Do@p p  | <3o0 Q0  | 0|5o"``  > LB | c $D LB | c $D` | 0;o  U7,785 2  | 0?o "  S129 2  | 0Co0p Q110 2  | 0D=o0"  O230  | 0Ko"`   : LB | c $D LB | c $D`  `  | 0Oo   S2,050 2   | 0Ro @  S1,560 2  !| 0Mo f  O804  "| 0Yo "  N85  #| 6<]o w  c 1-16&  +| 0ao VCA 2   ,| 0eoP VCA 2   -| 0co }  VCA 2   .| 0mo TCA   /| 0qo@ p '  W8,254 2  0| 0uo@"'  W2,019 2  1| 0yo0  W4,499 2  2| 0}o TUS   3| 0o  S7,785 2  4| 0\o   Q129 2  :| 0"o.  u!None has a valid injury diagnosis"(2"!  ;| <o@` WValid  =| <o` p  WValid  >| 6o` b ZV-code 2  ?| 0o` 6p  YInvalid  @| < QhK ` YInvalid  A| 6Th0  }Diagnosis chapter4 2  D C| 06___PPT9 |19.5*(" d  @`K  <h ?"` OF>6___PPT9 {1.6*(" d  @`C ~ <$h ?"`A  OF>6___PPT9 s2.1*(" d   @`C | <.h ?"` A OF>6___PPT9 s0.2*(" d   @`H z <Th ?"`  OF>6___PPT9 xU-Late effects$ " d   @`L S <7 ?"``VNF___PPT9(  l56.26(" d"  @`L Q <x7 ?"`VNF___PPT9(  l48.46(" d"  @`g O <,N ?"`A VNF___PPT9(  6.0>(" d&    @`g M <c ?"`A VNF___PPT9(  7.1>(" d&    @`a K <V ?"` VNF___PPT9(  Assault4 " d"    @`; > <n?`F>6___PPT9 y937.1&(" d  @`; < <$?F>6___PPT9 y678.7&(" d  @`5 : <?A F>6___PPT9 s100*(" d   @`5 8 <?A F>6___PPT9 s100*(" d   @`? 6 <]? F>6___PPT9 }All external causes$ " d   @`F x <?O`VNF___PPT9(  t71.0>(" d&  @`F w <č?OVNF___PPT9(  t45.2>(" d&  @`Y v <X?A OVNF___PPT9(  7.6>(" d&    @`Y u <?OA VNF___PPT9(  6.6>(" d&    @`Z t <? OVNF___PPT9(  Self-inflicted4 " d"    @`F s <X? ` VNF___PPT9(  t22.2>(" d&  @`F r <?  VNF___PPT9(  t14.0>(" d&  @`Y q <l?A  VNF___PPT9(  2.4>(" d&    @`Y p <? A  VNF___PPT9(  2.0>(" d&    @`W o <?   VNF___PPT9(   U-Poisoning4 " d "    @`> n <T? ` VNF___PPT9(  l18.66(" d"  @`> m <T?  VNF___PPT9(  l16.76(" d"  @`Y l <$i?A  VNF___PPT9(  2.0>(" d&    @`Y k <Hs? A VNF___PPT9(  2.5>(" d&    @`] j <8m?   VNF___PPT9(  U-Other transport4 " d"    @`> i <m?z ` VNF___PPT9(  l23.96(" d"  @`> h <9?z  VNF___PPT9(  l22.16(" d"  @`Y g <lC?A z  VNF___PPT9(  2.6>(" d&    @`Y f <^?z A VNF___PPT9(  3.3>(" d&    @`b e <|? z  VNF___PPT9(  U-MV non-traffic crash4 " d"    @`> d <䞹?E`z VNF___PPT9(  l80.06(" d"  @`> c <?Ez VNF___PPT9(  l67.56(" d"  @`Y b <?A Ez VNF___PPT9(  8.5>(" d&    @`Y a <4?EA z VNF___PPT9(  9.9>(" d&    @`^ ` <0? Ez VNF___PPT9(  U-MV traffic crash4 " d"    @`G _ <й?`EVNF___PPT9(  u446.2>(" d&  @`G ^ <xJT?EVNF___PPT9(  u313.8>(" d&  @`Z ] <ZT?A EVNF___PPT9(  47.6>(" d&    @`Z \ <QT?A EVNF___PPT9(  46.2>(" d&    @`c [ <T? EVNF___PPT9(  Unintentional (U-) Fall4 " d"    @` Y < T?``VNF___PPT9(  0 Rates/100,000 US approach CA approachz " d " d" "#" @`* W <T?`VNF___PPT9(  XP Percentages N=7,785 N=10,749 US approach CA approach5 " d " d & &&&'&  @`[ V <vT? `VNF___PPT9(   External cause B " d""$ @`ZB ~ s *1 ? ```ZB  s *1 ? `ZB  s *1 ? ` ZB  s *1 ?```ZB  s *1 ? `ZB  s *1 ?`ZB  s *1 ?`ZB  s *1 ? E`EZB  s *1 ?A A ZB  s *1 ?ZB  s *1 ? z `z ZB  s *1 ?  ` ZB  s *1 ?  ` ZB  s *1 ?  ` ZB  s *1 ? `TB 7 c $1 ? `ZB { s *1 ? O`OH  0޽h ? 3___PPT10i.L +D=' = @B +.  4-,->>P,(  Px P c $$ T $ `  T ^+  `< P# #"F:  `< P < LT?```N k2.2  @` P <Q?``N jSkin  @` P <DqQ? `N tOther accident  @` P <}Q?`N`< k1.8  @` P <Q?N`< lV-code  @`  P <̣Q? N< tOther accident  @`  P <Q?`s `` k2.3  @`  P <Q?s `` lV-code  @`  P <Q? s ` jMVTC  @`  P <Q?` `s  k2.4  @` P <Q? `s  uMusculoskeletal  @` P <0Q?  s  r Late effects     @` P <DQ?` `  k2.9  @` P <Q? `  uMusculoskeletal  @` P <Q?    tOther accident  @` P <Q?` `  k3.0  @` P <Q? `  q Respiratory     @` P <+P?    jFall  @` P <@.P?` `  k3.2  @` P <7P? `  uMusculoskeletal  @` P <LFP?    jFall  @` P <pOP?``  k3.5  @` P <P?`  uMental disorder  @` P <IP?   jFall  @` P <$ P?`` k3.8  @` P <dP?` nSymptoms    @` P <P?  kFall   @` P <rP?`` k6.6  @`  P <tP?` q Circulatory     @` !P <P?  jFall  @` "P <܎P?`` k8.8  @` #P <P?` uMental disorder  @` $P <СP?  tSelf-inflicted  @` %P <,P?`` l20.3  @` &P <8P?` lV-code  @` 'P <4(P?  jFall  @` (P <\P?`` r Percentage     @` )P <s+?` yDiagnosis chapter  @` *P < }+?  |External cause group  @``B +P 0o ? `ZB ,P s *1 ? `ZB -P s *1 ? `ZB .P s *1 ? `ZB /P s *1 ? `ZB 0P s *1 ? `ZB 1P s *1 ?  ` ZB 2P s *1 ?  ` ZB 3P s *1 ?  ` ZB 4P s *1 ?  ` ZB 5P s *1 ? s `s ZB 6P s *1 ? ````B 7P 0o ? <`<`B 8P 0o ?  <ZB 9P s *1 ?<ZB :P s *1 ?``<`B ;P 0o ?``<ZB P s *Do `H P 0޽h ? 3___PPT10i.W6V+D=' = @B +}  `$(  r  S Q $ `}  Q r  S Q$ ` Q H  0޽h ? 3___PPT10i.$OL+D=' = @B +    <(  <x < c $  $ `}   x < c $$    x < c $G$p `  H < 0޽h ? 3___PPT10i.PKy+D=' = @B +b  yq`;T (  Tr T S c $ `}   Wp  ` 9T #"" ` T <dm?J ` k 10,749  @` T <Pf?J  j 9,389  @` T <? J  :Records with a  valid E-code  @` T <T? `J  k 12,753  @`  T <(? J  k 12,754  @`  T <.?  J  Records that include an E-code  @`  T <:?`  k 14,772  @`  T <B?  k 14,773  @`  T < E?   "Initial number of records selected##"  @` T <\c ?` w PHAC$  @` T <l ? w CIHI$  @` T < ?  P  @``B T 0o ? `B T 0o ? `B T 0o ?  `B T 0o ?```B "T 0o ?`B #T 0o ?   `B 'T 0o ?``B )T 0o ?`` `B *T 0o ?  J `B .T 0o ?` `J `B 0T 0o ? 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