introduction - Wisconsin Safety Data Resource Portal

intro

Injury information can be used to track care from the motor vehicle crash scene, en route to the hospital, in the emergency room, after admission as a hospital in-patient, and through rehabilitative care. Injury tracking makes it possible for analysts to link specific characteristics of an event, person, or vehicle through medical intervention, outcome, and financial impacts. Hospital-based injury data, derived from national Uniform Billing Form standards, follows international reporting guidelines. The Wisconsin Hospital Association (WHA) and Wisconsin’s Department of Health Services (DHS) maintain the data.

WHA owns and manages the statewide Emergency Department Visit database (EDV), which has statewide data since 2002, and the Hospital Inpatient Discharge database, which has data for all inpatient discharges since 1989. WHA's PricePoint website has a basic query option, which allows users to check charges and utilization information for about 64 types of hospitalizations, representing about half of all hospital stays in Wisconsin, and a comprehensive query option for health data specialists and others familiar with medical terminology and coding. Patient discharge data may be purchased from the WHA Information Center.

DHS manages the mandatory Wisconsin Ambulance Run System (WARDS) database, which is available in electronic form from 1976 and is NEMSIS-compliant. Participation in Wisconsin Mortality Data, the CasePoint Coroner Data System, and the State Trauma Care System Registry are not mandatory and the data are not complete statewide. Summary injury and death data are available on-line via DHS's Wisconsin Interactive Statistics on Health (WISH) website. Access to injury data by governmental agencies and their contractors is controlled by DHS under terms of agreements with WHA.

The WHA Information Center collects data under a contract with the Wisconsin Department of Administration. DHS analysts link hospital discharge and emergency department visit data to Wisconsin's State Crash File annually. The linked data are evaluated and reported by the Center for Health Systems Research & Analysis, at UW-Madison, as part of Crash Outcome Data Evaluation System (CODES). Wisconsin's CODES project was one of the first in the nation, and has longitudinal data that goes back to 1994. CODES reports for vehicle, driver, and roadway factors are available on-line and researchers may obtain copies of linked files from the CODES analyst.

WISQARS (Web-based Injury Statistics Query and Reporting System) is an interactive database system operated by the Centers for Disease Control (CDC), which provides customized reports of injury-related data. The CDC's National Injury Data and Resources website is maintained by the National Center for Health Statistics and provides links to NCHS reports and databases related to injuries.

As several reports have noted, crash databases do not accurately describe the severity of crashes and under-report crash-related deaths.

Law enforcement, and national and state crash databases, use the KABCO scale (killed, incapacitating injury, non-incapacitating injury, possible injury, and property damage only) for injury severity, which is assigned by reporting officers at the scene. In these databases, the cause-of-death is attributed to the vehicle crash only if death occurs within 30 days.
Medical diagnosis and assignment of injury severity data uses the Abbreviated Injury Scale (AIS), and cause-of-death may be attributed to injuries sustained in a motor vehicle crash that had occurred more than 30 days earlier.

Some studies, including FHWA-HRT-05-051, have merged data from the AIS and KABCO scales for analysis.

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guidelines

NHTSA has produced the National Emergency Medical Service Information System (NEMSIS) to serve as a guideline for a uniform pre-hospital dataset, which applies to all EMS runs, not just those related to traffic crashes.
The American College of Surgeons (ACS) certifies trauma centers and provides guidelines for trauma registry databases and the National Trauma Databank.
Emergency department and in-patient billing data guidelines (UB-04) are available from the US Department of Health and Human Services’ Center for Medicare and Medicaid Services (CMS).
The World Health Organization (WHO) and the CDC’s National Center for Health Statistics (NCHS) define and maintain the International Classification of Diseases - Clinical Modification Codes, including E-codes for “external causes” of injury morbidity / mortality, which Wisconsin Vital Records has used since 1999 to code mortality data.
The CDC also sets standards for reporting to their injury database and use of the Public Health Information Network for data sharing.

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who uses the data?

Injury control data are used by public and private entities responsible for highway safety to target resources that will have a direct impact on reducing deaths, injuries, injury severity and health care costs caused by motor vehicle crashes.

- user summary adapted from NHTSA's Traffic Safety Information Systems Guidelines (2003)

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flowchart

injury data flowchart