ADEQUACY OF HOSPITAL DISCHARGE DATA FOR DETERMINING TRAUMA MORBIDITY PATTERNS

To determine the adequacy of hospital discharge data for describing th e nature and severity of multiple trauma, injury data coded from full hospital records were compared with injury data coded from discharge s ummaries for 83 plane crash survivors admitted to 14 different hospita ls. Full hospital records indicated that 33% sustained intracranial, 3 9% thoracic, and 27% abdominal/pelvic injuries, Thirty-five percent ha d spinal fractures, 40% upper limb fractures, and 70% lower limb fract ures, Discharge summary data missed 52% of the intracranial injuries, 28% of the thoracic injuries, and 30% of the spinal fractures, yet onl y missed 5% of the lower limb and 15% of the skull, pelvic, acid upper limb fractures. These differences point to concerns regarding the use of discharge data for determining the nature, severity, and sequelae of injuries, The observed underreporting of neurological injury sugges ts a need to re-evaluate discharge data systems for measuring brain an d spinal cord injury patterns, particularly given the increasing relia nce on these systems for health policy and programmatic decision makin g.