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Measuring Injury Using the National Health Interview Survey. Margaret Warner, PhD Lois A. Fingerhut, MA Pat Barnes, MA. Location of injury and poisoning data. Injury Episode file Injury Verbatim file Poison Episode file Person file. Injury episode file. For each person:

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measuring injury using the national health interview survey

Measuring Injury Using the National Health Interview Survey

Margaret Warner, PhD

Lois A. Fingerhut, MA

Pat Barnes, MA

location of injury and poisoning data
Location of injury and poisoning data
  • Injury Episode file
  • Injury Verbatim file
  • Poison Episode file
  • Person file
injury episode file
Injury episode file
  • For each person:
    • Up to 4 injury episodes
  • For each episode:
    • Up to 4 ICD-9-CM diagnosis codes
    • Up to 3 ICD-9-CM external cause codes
available data in the injury episode file
Available data in the Injury Episode file
  • External cause (ICD-9-CM)
  • Injury diagnoses (ICD-9-CM)
  • Place of occurrence
  • Activity
  • Resulting limitations
  • Detail on certain causes (e.g. mv crashes, falls)
injury episode file5
Injury episode file

ICD-9-CM diagnosis codes and E-codes are based on information supplied by respondents, not medically trained personnel.

poisoning episode file
Poisoning episode file
  • Contains no ICD-9-CM codes or E-codes
  • Contains 47 episodes coded as “Allergic/adverse reaction to medical or other substance” or “Something else – not poisoning”
available data in the poisoning episode file
Available data in the Poisoning Episode file
  • Cause of poisoning
  • Call to poison control center
available data in both injury and poisoning files
Available data in both injury and poisoning files
  • Date of episode
  • Hospitalization
  • Days out of school
  • Days out of work
  • Time elapsed between episode and interview
injury section person file
Injury section–Person file
  • Contains summary information about injury and poisoning episodes
  • Annual estimates can only be made on variables INJCT and POICT
injury and poisoning episode and injury verbatim files
Injury and poisoning episode, and injury verbatim files
  • Contain only injury or poisoning information and unique identifiers
  • Must be linked to the person file to obtain sociodemographic variables, design variables, etc.
episode and person based files
Episode and person based files

Episode based: A person will appear in these files as many times as he/she has a unique episodes

Person based: A person will appear in this file only once

concatenating injury and poisoning episode files
Concatenating injury and poisoning episode files

+

Injury

Poisoning

Injury

Poisoning

= Missing data, questions not found in both files

merging injury poisoning episode file and person file
Merging injury/poisoning episode file and person file

+

Injury

Person

Poisoning

= Missing data, questions not found in both files

merged injury poisoning episode file and person file
Merged injury/poisoning episode file and person file

Injury

Poisoning

Person

= Missing data, questions not found in both files

episodes and conditions
Episodes and Conditions
  • Episode = Event that caused the condition (e.g. fall down stairs)
  • Conditions = physical harm resulting from the injury episode (e.g. broken leg, bruised arm)
creating condition files injury
Creating condition filesInjury

Injury Episode with ICD9_1 ICD9_2 ICD9_3 ICD9_4

ICD9_1

ICD9_2

ICD9_3

ICD9_4

creating condition files poisoning
Creating condition filesPoisoning

Poisoning episode

Poisoning condition

=

concatenating injury and poisoning condition files
Concatenating injury and poisoning condition files

+

Injury conditions

Poisoning

Injury conditions

Poisoning conditions

= Missing data, questions not found in both files

handout
Handout
  • Using SAS to manipulate the injury and poisoning data
  • Example SAS programs for concatenating and merging the files
analyzing the injury and poisoning data
Analyzing the injury and poisoning data
  • Estimates of frequency
  • Percent distributions
  • Rates
  • Standard errors
calculating annual estimates
Calculating annual estimates
  • Annual est = (variable)(4)(WTFA)
  • Annual estimates of episodes and conditions can be calculated.
  • Annual estimates of the number of persons injured cannot be calculated due to the 3 month reference period.
standard errors se
Standard Errors (SE)
  • SE of the injury/poisoning rate for males and females
  • SE of the injury/poisoning rate for specified racial groups
estimates of frequency examples
Estimates of frequencyExamples
  • Number of episodes resulting from specific causes
  • Number of injury/poisoning episodes by sex
  • Number of injury/poisoning episodes by mechanism
rates examples
RatesExamples
  • Annual injury/poisoning rates for males and females
  • Annual injury/poisoning rates by mechanism
  • Annual rate of falls for females over 65 years of age
injury and poisoning episode rates
Injury and poisoning episode rates

Age in years

95% CI

Episodes per 1,000 population

percentages examples
PercentagesExamples
  • Percent of episodes resulting from specific causes
  • Percent of poisoning episodes in which a poison control center was called
  • Percent of injury episodes that occurred in the home
percent of injury episodes by place of injury 1997
Percent of injury episodes by place of injury, 1997

Percent of episodes

Persons could indicate up to two places per episode.

work related injuries
Work-related injuries
  • Injury episode file:
  • Activity at the time of injury=
    • Working at a paid job
  • Sample person file:
  • Occupation and industry
percent of injury episodes by activity 1997
Percent of injury episodes by activity, 1997

Percent of episodes

Persons could indicate up to two places per episode.

injury verbatim file
Injury verbatim file
  • Responses recorded by the interviewer:
    • How the injury occurred
    • Body part injured
    • Nature of injury
  • Text file linkable to other files
available data in injury verbatim
Available data in injury verbatim
  • How the injury occurred (up to 336 characters)
  • Up to 4 body parts injured (up to 34 characters each)
  • Up to 4 nature of injuries (up to 44 characters each)
injury verbatim file37
Injury verbatim file
  • Edited only for confidentiality
  • Grammatical and/or spelling errors were not corrected
uses of injury verbatim
Uses of injury verbatim
  • NCHS used to code ICD-9-CM diagnoses and external causes
  • Code according to other classification schemes (e.g. BLS, ICECI, etc)
  • Text search for words of interest
  • In-depth analysis of ICD-9-CM categories
check sample size
Check sample size

Analysts should be cautioned against making estimates based on small numbers of observations.

verbatim text example
Cause of injury: .

Part of body:

Type of injury:

“While <in-line skating>, fell on thumb.”

“Right thumb”

“Broken”

Verbatim textExample
examples of verbatim machinery related injuries e919
Examples of verbatimMachinery related injuries (E919)
  • “He was at home working on his table saw and accidentally ran his left thumb through the machine lengthwise.” (table saw, n=8)
  • “Forklift extension came loose dropping on right foot at work” (forklift, n=3)
contact for questions related to injury data or injury classification issues mwarner@cdc gov
Contact for questions related to injury data or injury classification issues:MWarner@cdc.gov