The reliability of information on work-related injuries available from hospitalisation data in Australia
Version of Record online: 4 AUG 2009
© 2009 The Authors. Journal Compilation © 2009 Public Health Association of Australia
Australian and New Zealand Journal of Public Health
Volume 33, Issue 4, pages 332–338, August 2009
How to Cite
McKenzie, K., Mitchell, R., Scott, D. A., Harrison, J. E. and McClure, R. J. (2009), The reliability of information on work-related injuries available from hospitalisation data in Australia. Australian and New Zealand Journal of Public Health, 33: 332–338. doi: 10.1111/j.1753-6405.2009.00404.x
- Issue online: 4 AUG 2009
- Version of Record online: 4 AUG 2009
- Submitted: December 2008 Revision requested: April 2009 Accepted: May 2009
- wounds and injuries;
- validation studies as topic;
- International Classification of Diseases;
- medical records
Objective: To examine the reliability of work-related activity coding for injury-related hospitalisations in Australia.
Method: A random sample of 4,373 injury-related hospital separations from 1 July 2002 to 30 June 2004 were obtained from a stratified random sample of 50 hospitals across four states in Australia. From this sample, cases were identified as work-related if they contained an ICD-10-AM work-related activity code (U73) allocated by either: (i) the original coder; (ii) an independent auditor, blinded to the original code; or (iii) a research assistant, blinded to both the original and auditor codes, who reviewed narrative text extracted from the medical record. The concordance of activity coding and number of cases identified as work-related using each method were compared.
Results: Of the 4,373 cases sampled, 318 cases were identified as being work-related using any of the three methods for identification. The original coder identified 217 and the auditor identified 266 work-related cases (68.2% and 83.6% of the total cases identified, respectively). Around 10% of cases were only identified through the text description review. The original coder and auditor agreed on the assignment of work-relatedness for 68.9% of cases.
Conclusions and implications: The best estimates of the frequency of hospital admissions for occupational injury underestimate the burden by around 32%. This is a substantial underestimate that has major implications for public policy, and highlights the need for further work on improving the quality and completeness of routine, administrative data sources for a more complete identification of work-related injuries.