1. Developing a National Injury Surveillance System ARGENTINA ICE on Injury Statistics Meeting Cuernavaca, Mexico. 1-2 June 2005 Dr. Marta Vacchino. MSc Epidemiology ANLIS-National Institute of Epidemiology Dr Juan H. Jara. Ministry of Health and Environment e-mail: vacchino@mdp.edu.ar investigacion@ine.gov.ar

2. Injury Surveillance System: Sistema de Vigilancia de Lesiones por Causa Externa. (S.I.V.I.L.E) Started: September 2003 System design and piloting: until March 2004 System entry and training: from April 2004 Working units: from October 2004 Evaluation: from June 2005

3. Injuries in the World, America and Argentina PROPOSAL OF SENTINEL UNITS Descriptive epidemiology Time, place, person What is a surveillance system? Presentation: Instrument for data collection APPLICATION EXERCISES TRAINING WORKSHOPS

4. Recall: Elements of a Surveillance System. Health Care System Public Health Authority Event Data Information Intervention (Feedback) Reporting Analysis & Interpretation Expected changes Decision

5. Developing a national injury surveillance system Health Care System Public Health Authority Data Information Reporting HEALTH EVENT Injuries: the physical damage that results when a human body is suddenly subjected to intolerable levels of energy. bodily lesion resulting from acute exposure to energy in amounts that exceed the threshold of physiological tolerance or impairment of function resulting from a lack of one or more vital elements. time between exposure and injury is short

6. Developing a national injury surveillance system Health Care System Public Health Authority Data Information Intervention DATA SOURCE Selected sites (sentinel approach) Emergency Medical Services, pre-hospital emergency Hospital emergency departments, hospital inpatient services Mostly public sector. Voluntary entry

7. Sentinel Units. Components Clinical Epidemiological Statistic Actions: filling questionnaire, injury diagnosis and treatment Actions: filling questionnaire, injury diagnosis and treatment Actions: local data analysis and interpretation, local dissemination Actions: local data analysis and interpretation, local dissemination Actions: data entry, help in data analysis and local result dissemination Actions: data entry, help in data analysis and local result dissemination

8. Developing a national injury surveillance system Health Care System Public Health Authority Data Information Intervention CASE DEFINITION Any person who demands assistance to Sentinel Unit for any type of injury, intentional or unintentional, for all age groups, first visit for treatment of that injury. I.D.C-10 and ICECI recommendations

9. Developing a national injury surveillance system Health Care System Public Health Authority Event Data Information Intervention Reporting frequency Immediate Web-based system

10. Ministry of Health and Environment Peripheral level Health care system Sentinel Units Central level Developing a national injury surveillance system: Data flow

11. Developing a national injury surveillance system Health Care System Public Health Authority Event Intervention Data Analysis It is automated Data characteristics Basic descriptive analysis, tables and graphs

12. Developing a national injury surveillance system Health Care System Public Health Authority Event Intervention Acceptability. Reliability (sensitivity and positive predictive value). Sustainability. Timeliness. System Evaluation

13. Where we are today!!! Sentinel Units: 52 República Argentina. May 2005 Where we are today!!! Sentinel Units: 52 República Argentina. May 2005 Some Jurisdictions Province of Buenos Aires and Buenos Aires City Phase 0 – No proposal Phase I – Some proposal Phase II - Received formative assessment Phase III - Proof / PC/ Connection Phase IV – System working REFERENCES

14. strength government support national coverage sentinel approach reliable and valid data on line system weakness measure trends must define different unit profiles not easy to do extrapolations opportunity voluntary entry motivated recorders threat lack of human resources work overload Challenges !! : SWOT MATRIX