Implications of using administrative healthcare data to identify risk of motor vehicle crash-related injury: the importance of distinguishing crash from crash-related injury.

Autor: Joyce NR; Department of Epidemiology, Brown University School of Public Health, 121 South Main St., Box G-121-S2, Providence, RI, 02192, USA. Nina_Joyce@Brown.edu.; Center for Gerontology and Health Care Research, Brown University School of Public Health, Providence, RI, USA. Nina_Joyce@Brown.edu., Lombardi LR; Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA., Pfeiffer MR; Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA., Curry AE; Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA.; Department of General Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA., Margolis SA; Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA.; Warren Alpert Medical School of Brown University, Providence, RI, USA., Ott BR; Warren Alpert Medical School of Brown University, Providence, RI, USA., Zullo AR; Department of Epidemiology, Brown University School of Public Health, 121 South Main St., Box G-121-S2, Providence, RI, 02192, USA.; Center for Gerontology and Health Care Research, Brown University School of Public Health, Providence, RI, USA.
Jazyk: angličtina
Zdroj: Injury epidemiology [Inj Epidemiol] 2024 Aug 12; Vol. 11 (1), pp. 38. Date of Electronic Publication: 2024 Aug 12.
DOI: 10.1186/s40621-024-00523-3
Abstrakt: Background: Administrative healthcare databases, such as Medicare, are increasingly used to identify groups at risk of a crash. However, they only contain information on crash-related injuries, not all crashes. If the driver characteristics associated with crash and crash-related injury differ, conflating the two may result in ineffective or imprecise policy interventions.
Methods: We linked 10 years (2008-2017) of Medicare claims to New Jersey police crash reports to compare the demographics, clinical diagnoses, and prescription drug dispensings for crash-involved drivers ≥ 68 years with a police-reported crash to those with a claim for a crash-related injury. We calculated standardized mean differences to compare characteristics between groups.
Results: Crash-involved drivers with a Medicare claim for an injury were more likely than those with a police-reported crash to be female (62.4% vs. 51.8%, standardized mean difference [SMD] = 0.30), had more clinical diagnoses including Alzheimer's disease and related dementias (13.0% vs. 9.2%, SMD = 0.20) and rheumatoid arthritis/osteoarthritis (69.5% vs 61.4%, SMD = 0.20), and a higher rate of dispensing for opioids (33.8% vs 27.6%, SMD = 0.18) and antiepileptics (12.9% vs 9.6%, SMD = 0.14) prior to the crash. Despite documented inconsistencies in coding practices, findings were robust when restricted to claims indicating the injured party was the driver or was left unspecified.
Conclusions: To identify effective mechanisms for reducing morbidity and mortality from crashes, researchers should consider augmenting administrative datasets with information from police crash reports, and vice versa. When those data are not available, we caution researchers and policymakers against the tendency to conflate crash and crash-related injury when interpreting their findings.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: