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Completeness of cause of injury coding in healthcare administrative databases in the United States, 2001
  1. J H Coben1,
  2. C A Steiner2,
  3. M Barrett3,
  4. C T Merrill4,
  5. D Adamson4
  1. 1Injury Control Research Center, West Virginia University, Morgantown, WV, USA
  2. 2Agency for Healthcare Research and Quality, Center for Delivery, Organization, and Markets, Rockville, MD, USA
  3. 3M.L. Barrett, Inc, San Diego, CA, USA
  4. 4Medstat, Washington, DC, USA
  1. Correspondence to:
 Dr J H Coben
 Injury Control Research Center, West Virginia University, PO Box 9151, Morgantown, WV 26506-9151, USA; jcoben{at}


Objectives: To determine the completeness of external cause of injury coding (E-coding) within healthcare administrative databases in the United States and to identify factors that contribute to variations in E-code reporting across states.

Design: Cross sectional analysis of the 2001 Healthcare Cost and Utilization Project (HCUP), including 33 State Inpatient Databases (SID), a Nationwide Inpatient Sample (NIS), and nine State Emergency Department Databases (SEDD). To assess state reporting practices, structured telephone interviews were conducted with the data organizations that participate in HCUP.

Results: The percent of injury records with an injury E-code was 86% in HCUP’s nationally representative database, the NIS. For the 33 states represented in the SID, completeness averaged 87%, with more than half of the states reporting E-codes on at least 90% of injuries. In the nine states also represented in the SEDD, completeness averaged 93%. Twenty two states had mandates for E-code reporting, but only eight had provisions for enforcing the mandates. These eight states had the highest rates of E-code completeness.

Conclusions: E-code reporting in administrative databases is relatively complete, but there is significant variation in completeness across the states. States with mandates for the collection of E-codes and with a mechanism to enforce those mandates had the highest rates of E-code reporting. Nine statewide ED data systems demonstrate consistently high E-coding completeness.

  • AHRQ, Agency for Healthcare Research and Quality
  • CSTE, Council of State and Territorial Epidemiologists
  • HCUP, Healthcare Cost and Utilization Project
  • NHAMCS, National Hospital Ambulatory Medical Care Survey
  • NIS, Nationwide Inpatient Sample
  • SEDD, State Emergency Department Databases
  • SID, State Inpatient Databases
  • E-codes
  • injury coding
  • administrative data

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  • Competing interests: none declared.