1. 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

2. 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

3. 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

4. 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

5. Crash related: motor vehicle traffic, pedal cyclist (other), pedestrian(other), other transport.
Louisiana Hospital Discharge Data, 2014 Q1-2015Q3.

6. 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

7. CFOI :about 1/3 of crashes involve another vehicle;
LA data 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

8. PILOT PROJECT
Link LACRASH reports with hospitalization and death records in order to improve the quality and accuracy of LACRASH injury outcome data.

9. 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

10. 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

11. 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

12. 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

13. Results: CRASH Injury Fatal Severe Moderate Total 29% 8%
Annual Average
177
585
4359
5120
% match
29% 8%

14. 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 days after crash
5 (13%)
Cause of death
Chronic condition 21
Trauma/other/unknown
Suicide/homicide 8

15. 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

16. 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

17. Questions? Comments? More information:
Michelle Lackovic –
Jane Herwehe –
Jay Besse –
Thank you.