Impact of Double Counting and Transfer Bias on Estimated Rates and Outcomes of Acute Myocardial Infarction

Westfall, John M.; McGloin, Joe

doi:10.1097/00005650-200105000-00006

Cited by 51 publications

(41 citation statements)

References 12 publications

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“…To reduce the possibility of double counting, hospitalizations of patients who were discharged to another short-term care facility were not included in the analysis. 14 Infants ,1 day old were also excluded because these cases were predominantly normal newborns. National weighted estimates of all hospitalized children aged 0 to 3 years with any ICD-9-CM diagnosis code for maltreatment (995.50-995.59) or an E-code (E960-E967.9) for assault were calculated excluding sexual abuse, emotional abuse, and neglect.…”

Section: E1796mentioning

confidence: 99%

Trends in Hospitalization Rates and Severity of Injuries From Abuse in Young Children, 1997–2009

Farst

Ambadwar²,

King³

et al. 2013

Pediatrics

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OBJECTIVES: To examine trends in incidence of hospitalizations for injury from abuse in young children from 1997 through 2009 and to examine injury severity trends. METHODS: Cases were identified in the National Inpatient Sample database of the Healthcare Cost and Utilization Project by using International Classification of Diseases, Ninth Revision, Clinical Modification codes for child maltreatment and external cause of injury for assault in children aged 0 through 3 years. Incidence was calculated by age, gender, and region. Trends in incidence of hospitalization and injury severity were calculated over time. RESULTS: Hospitalization rates for injury from abuse showed no significant change over the study period, ranging from a low of 2.10 per 10 000 children in 1998 to a high of 3.01 per 10 000 children in 2005 (P = .755). Children aged <1 had significantly higher hospitalization rates for injury from abuse (6.01 vs 1.12, P <.001) and higher mean injury severity scores compared with children aged 1 to 3 years (12.50, SD = 0.14 vs 8.56, SD = 0.21, P <.001). Injury severity scores increased significantly over the study period. CONCLUSIONS: No significant change in hospitalization rates for injury from abuse among young children was observed from 1997 to 2009. These results coincide with other reports of stable or modestly increasing rates of serious physical abuse or death in young children but not with reports from child welfare data showing declines in physical abuse during the same period. Diverse sources of data may provide important complementary methods to track child abuse.

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Section: E1796mentioning

confidence: 99%

Trends in Hospitalization Rates and Severity of Injuries From Abuse in Young Children, 1997–2009

Farst

Ambadwar²,

King³

et al. 2013

Pediatrics

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“…To avoid overestimating the ATV-related injury incidence because of double-counting, hospitalizations (n ϭ 44) that resulted in transfer to another short-term hospital were excluded from analysis. 21 Short-term hospital transfers were retained for analysis of charges. …”

mentioning

confidence: 99%

National Hospitalization Impact of Pediatric All-Terrain Vehicle Injuries

Killingsworth

Tilford²,

Parker³

et al. 2005

Pediatrics

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ABSTRACT. Objective. All-terrain vehicle (ATV) injuries among children represent a significant and growing problem. Although state-level analyses have characterized some aspects of pediatric ATV-related injuries, little information on the national impact on hospitalization is available. This study was designed to characterize more fully the patterns of injury, hospital length of stay, and hospital charges associated with ATV-related injuries, with a nationally representative sample.Methods. Analyses were based on the 1997 and 2000 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID). The KID is the only national, all-payer database of hospital discharges for children. KID data were weighted to represent all discharges from general hospitals in the United States. Discharges with external cause-of-injury codes consistent with off-road ATV-related injuries were selected, and the affected population was described. Nationally representative rates of ATVrelated injuries were calculated, and changes between 1997 and 2000 were documented.Results. An estimated 5292 children were hospitalized because of ATV-related injuries during the 2-year period, and hospitalizations increased 79.1% between 1997 and 2000. Rates of ATV-related hospitalization were highest among adolescent white male subjects, consistent with previous studies. Most patients had hospital lengths of stay of <4 days (68%), but 10% had stays of >8 days. Injury severity varied considerably, with more than one third of patients sustaining moderate to severe injuries. Approximately 1% of hospitalizations resulted in in-hospital deaths. Total hospital charges for this injury mechanism were $74 367 677 for the 2-year study period. Most of these charges were paid by private insurers.Conclusions. This study provides evidence supporting recent substantial increases in childhood ATV-related injuries. The hospitalization impact of ATV-related injuries among children is considerable. Our data support the need for ongoing creative attempts to identify effective strategies to decrease ATV injuries among children. P ediatric all-terrain vehicle (ATV)-related injuries represent a significant and growing problem. ATVs have been sold in the United States since 1972 and have experienced a popularity surge in recent years. 1 Accompanying this increase in popularity is concern regarding the associated risks for children who ride on or drive ATVs. Current discussions have centered on appropriate vehicle sizes for children and the potential for legislative and educational measures to decrease the ATV injury burden.ATVs are 3-or 4-wheeled machines designed with motorcycle-style handlebars, a high center of gravity, and large, low-pressure tires intended for off-road use. ATVs typically range in engine size from 50 cm 3 to Ͼ500 cm 3 of displacement and can weigh as much as 600 pounds. Nearly all ATVs are designed for 1 rider, because precise, quickly executed, weight-distribution adjustments must be performed to maintain balance and control of the vehicle in turns...

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“…The NIS contains no unique identifiers, so to reduce the effects of double counting multiple hospitalizations for the same drowningrelated injury, the hospitalizations of patients who were discharged to another short-term care hospital were not included in the analysis (ie, only the terminal hospital admission was included). 12 This assumes that these cases would likely be captured at the point of the definitive drowning care in the receiving hospital records.…”

Section: Methodsmentioning

confidence: 99%

Trends in US Pediatric Drowning Hospitalizations, 1993–2008

et al. 2012

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BACKGROUND: In the United States, drowning is the second leading cause of unintentional injury death in children aged 1 to 19 years, accounting for nearly 1100 deaths per year. Although a decline in overall fatal drowning deaths among children has been noted, national trends and disparities in pediatric drowning hospitalizations have not been reported. METHODS: To describe trends in pediatric drowning in the United States and provide national benchmarks for state and regional comparisons, we analyzed existing data (1993–2008) from the Nationwide Inpatient Sample, the largest, longitudinal, all-payer inpatient care database in the United States. Children aged 0 to 19 years were included. Annual rates of drowning-related hospitalizations were determined, stratified by age, gender, and outcome. RESULTS: From 1993 to 2008, the estimated annual incidence rate of pediatric hospitalizations associated with drowning declined 49% from 4.7 to 2.4 per 100 000 (P < .001). The rates declined for all age groups and for both males and females. The hospitalization rate for males remained consistently greater than for females at each point in time. Rates of fatal drowning hospitalization declined from 0.5 (95% confidence interval, 0.4–0.7) deaths per 100 000 in 1993–1994 to 0.3 (95% confidence interval, 0.2–0.4) in 2007–2008 (P < .01). No difference was observed in the mean hospital length of stay over time. CONCLUSIONS: Pediatric hospitalization rates for drowning have decreased over the past 16 years. Our study provides national estimates of pediatric drowning hospitalization that can be used as benchmarks to target and assess prevention strategies.

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Impact of Double Counting and Transfer Bias on Estimated Rates and Outcomes of Acute Myocardial Infarction

Cited by 51 publications

References 12 publications

Trends in Hospitalization Rates and Severity of Injuries From Abuse in Young Children, 1997–2009

Trends in Hospitalization Rates and Severity of Injuries From Abuse in Young Children, 1997–2009

National Hospitalization Impact of Pediatric All-Terrain Vehicle Injuries

Trends in US Pediatric Drowning Hospitalizations, 1993–2008

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