Hospitalizations for injury among American Indian youth in Washington

Objective To determine the rate and causes of hospitalization for injury am ong American Indian and Alaska Native (AI/AN)youth in Washington compared w ith youth of all races. Methods Subjects were aged 0 to 19 years and were a dmitted to civilian hospitals for care of an injury (International Classifi cation of Diseases N codes 800-995) in Washington between 1990 and 1994. De aths occurring in the pre-hospital setting and emergency department were no t included. Using several fields of identifying information, the Washington state hospital discharge database was linked with the Indian Health Servic e (IHS) patient registration database to identify AI/AN youth. Denominator data included the total age-specific IHS user population for American India ns and population estimates derived from the US Census. Incidence ratios (I Rs) were calculated to compare rates of hospitalization between AI/AN youth and all youth in Washington. Results A total of 694 hospitalizations for i njury were identified for AI/AN youth and 29,048 were identified for all ra ces. The rate of hospitalization for injuries among AI/AN youth was 507 dis charges per 100,000 youth (IR = 1.30; 95% confidence interval [CI] 1.20 to 1.40). The leading mechanism of injury was motor vehicles (IR 1.73, 95% CI 1.49 to 2.01), which was followed by falls (IR 0.95, 95% CI 0.79 to 1.15) a nd poisonings (IR 1.20, 95% CI 0.80 to 1.78), The disparity was greater for intentional injuries (IR 1.71, 95% CI 1.44 to 2.04). The highest IR for al l unintentional injuries was for injuries from fire (IR 2.35, 95% CI 1.42 t o 3.87). AI/AN children aged 15 to 19 had the greatest disparity for rates of injury hospitalization (IR 1.4, 95% CI 1.25 to 1.56). Conclusion AI/AN y outh in Washington had a higher rate of hospitalization for injury compared with all youth in the state. Disparities were greatest for injuries relate d to motor vehicles and assaults. When linked, hospital discharge data can be used for surveillance of AI/AN hospitalizations.