Laurel Harduar Morano1, David Richardson2, Scott Proescholdbell3. 1. Department of Emergency Medicine, Center for Health Informatics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 2. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 3. Injury and Violence Prevention Branch, NC Division of Public Health, Raleigh, North Carolina.
Abstract
BACKGROUND: Use of worker's compensation (WC) as payer underestimates work-related (WR) injuries. We evaluated three methods to identify WR injuries: WC as payer, ICD-9-CM work-status codes E000.0/E000.1, and other ICD-9-CM external cause codes. METHODS: We identified injury-related emergency department visits from North Carolina's syndromic surveillance system (2010-2013). Characteristics were compared by indicator. We manually reviewed 800 admission notes to confirm if the visit was WR or non-WR; WR keywords from the review were applied to all visits. RESULTS: 133 156 injury-related visits (age, 16 years or older) were identified: WC = 69%, work-status codes = 18%, other ICD-9-CM codes = 13%. Among manually reviewed visits: few visits identified by WC (0.3%) or work-status codes (2%) were non-WR, while 12% of other ICD-9-CM code identified visits were non-WR; 53%, 46%, and 31% of visits identified by WC, work-status codes, and other ICD-9-CM codes were WR, respectively. CONCLUSIONS: Findings support use of WC and work-status codes to capture WR injuries; other ICD-9-CM codes should be used with caution or in combination with other indicators.
BACKGROUND: Use of worker's compensation (WC) as payer underestimates work-related (WR) injuries. We evaluated three methods to identify WR injuries: WC as payer, ICD-9-CM work-status codes E000.0/E000.1, and other ICD-9-CM external cause codes. METHODS: We identified injury-related emergency department visits from North Carolina's syndromic surveillance system (2010-2013). Characteristics were compared by indicator. We manually reviewed 800 admission notes to confirm if the visit was WR or non-WR; WR keywords from the review were applied to all visits. RESULTS: 133 156 injury-related visits (age, 16 years or older) were identified: WC = 69%, work-status codes = 18%, other ICD-9-CM codes = 13%. Among manually reviewed visits: few visits identified by WC (0.3%) or work-status codes (2%) were non-WR, while 12% of other ICD-9-CM code identified visits were non-WR; 53%, 46%, and 31% of visits identified by WC, work-status codes, and other ICD-9-CM codes were WR, respectively. CONCLUSIONS: Findings support use of WC and work-status codes to capture WR injuries; other ICD-9-CM codes should be used with caution or in combination with other indicators.
Authors: Ali Pourmand; Keith S Boniface; Katherine Douglass; Colton Hood; Sarah E Frasure; Jeremy Barnett; Kunj Bhatt; Neal Sikka Journal: Cureus Date: 2021-11-13