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
- injury coding
- administrative data
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