Linking CRASH Data with Health Data Systems Improving motor vehicle safety through public health partnership Michelle Lackovic - Louisiana Public Health Institute Jane Herwehe - Louisiana Department of Health Jay Besse - Louisiana Department of Health August 2017 HANNAH WILL FIX ADD DATE AND AFFILIATION
Objectives: Improve motor vehicle crash surveillance by linking crash data to medical data for more complete information and better understanding of crash injury outcomes Promote exchange and accessibility of data among stakeholders and foster increased collaboration among public health and motor vehicle safety agencies
Partners: Louisiana Department of Health Bureau of Family Health Occupational Health & Injury Surveillance Program Bureau of Health Informatics Louisiana Highway Safety Research Group and DOTD
MVC is a significant public health problem: Motor vehicle crashes = 3rd leading cause of fatal and non fatal injury for LA residents Motor vehicle crashes = single largest cause of death for workers MVC fatalities cost the state $1.04 billion in medical and work loss costs Total deaths 777 Deaths Medical costs $6.1 Million Work loss costs $1.03 Billion Combined cost $1.04 Billion
Crash related: motor vehicle traffic, pedal cyclist (other), pedestrian(other), other transport. Louisiana Hospital Discharge Data, 2014 Q1-2015Q3.
Firearm related Poisoning Crash-related Suicides Homicides Crash related: motor vehicle traffic, pedal cyclist (other), pedestrian(other), other land transport, other transport. MVC fatalities cost the state $1.04 billion in medical and work loss costs Louisiana Vital Records, 2015
CFOI :about 1/3 of crashes involve another vehicle; LA data 2010-2015 about 15% of all fatalities involve a commercial vehicle although overall commercial vehicles only involved in 3% of all crashes Total deaths 777 Deaths Medical costs $6.1 Million Work loss costs $1.03 Billion Combined cost $1.04 Billion
PILOT PROJECT Link LACRASH reports with hospitalization and death records in order to improve the quality and accuracy of LACRASH injury outcome data.
Data sources: LACRASH Obtained from DOTD and the Highway Safety Research Group Date of crash = 2012, 2013, or 2014 Injury = fatal, severe, or moderate Location of crash (parish) = Caddo, East Baton Rouge, Orleans, Rapides, Tangipahoa Approximately 5100 records per year Limited dataset: Name, DOB (driver only), age (occupant(s)), person type [e.g., driver, occupant, pedestrian, bicycle], sex, race, home zip and city, date/time of crash, transported, and injury
Data sources: Death Certificates Access through pre-existing data sharing agreement Approximately 50,000 deaths per year Data Fields: Personal identifiers, date of birth/death, underlying/contributory cause of death narrative & code(s) Additional information collected if its an injury: date, location, type of injury, work-relatedness
Data sources: Inpatient Hospitalizations BHI primary data owner Approximately 500,000 hospitalizations per year Data Fields: Name, DOB, address, hospital, date/time admission, primary & secondary diagnosis, injury codes, discharge disposition, costs Calculated injury severity translates diagnosis codes into standard injury severity categories Facilitates use of data Approximately 23,000 injury cases
Linkage: Probabilistic Main data elements: Race Dates (crash, hospitalization, death, injury (death certificate) Name Location (accident, residence) Date of birth\age Injury codes/narratives Gender Injury severity LACRASH Fatal Severe Moderate Possible No injury Injury severity ICDMAP Fatal Critical Severe Serious Moderate Minor
Results: CRASH Injury Fatal Severe Moderate Total 29% 8% Annual Average 177 585 4359 5120 % match 29% 8%
Results: Fatalities Was motor vehicle crash coded on the death certificate? YES (N=43) NO (39 cases) #/% cases Date of death < 30 days after the crash 28 (65%) Date death=date crash 28 (72%) Date of death > 30 days after the crash 15 (35%) Date of death 2-10 days after crash 6 (15%) Date of injury = date of crash 10 Date of death 11-27 days after crash 5 (13%) Cause of death Chronic condition 21 Trauma/other/unknown Suicide/homicide 8
Additional observations: External linkage can identify data errors Duplicate records Wrong date of crash, date of birth, age, misspellings Some hospitalization\death records did not contain any MVC codes Limitations Lag time for health systems data (~ 1-2 years) Difficult to obtain ED data Limited record match
Next steps: Used pilot project to leverage TRCC funding for ongoing work Improved injury surveillance Establish data sharing agreement Statewide data Conduct 2 research projects Improved system integration & data accessibility Standardized coding & calculation of data elements Enhanced partnership between public health and motor safety agencies
Questions? Comments? More information: Michelle Lackovic – mlackovic@lphi.org Jane Herwehe – jane.herwehe@la.gov Jay Besse – jay.besse@la.gov Thank you.