INFORMATION RESOURCES ON AVOIDABLE INJURY
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Sources of Data
Hospital Episode Statistics (HES)
HES provides information on admitted patient care delivered by NHS hospitals in England from 1989 onwards. Each financial year around 12 million records for inpatients and day cases are generated containing data such as age, sex, dates of admission and discharge, diagnoses and operations and procedures.
HES provides a comprehensive picture of inpatient care that can support public health analysis, planning and resource allocation, benchmarking, clinical audit, monitoring and performance management and research. It can offer a longitudinal picture of particular conditions or procedures. It can support local NHS analysis of activity and allows comparisons between Trusts, PCTs, SHAs, LAs, etc. In addition it also provides data for the construction of a large percentage of the NHS Performance Indicators which summarise quality and performance in the NHS.
Annual mortality statistics published by the Office for National Statistics give numbers of deaths by cause by area of residence. Numbers of deaths from all 'external causes of injury and poisoning' can be further broken down by a number of sub-groupings.
The National Centre for Health Outcomes Development is a national resource concerned with all aspects of health outcomes assessment. One of its main activities is production of comparative health outcome indicators using available routine data; in the form of the Compendium of Clinical and Health Indicators.
The Compendium is an annual set of some 1,000 comparative analyses of data at national and sub-national levels (government office region, strategic health authority, primary care organisation, local authority and hospital level) as appropriate. The Compendium brings together indicators from several data sets developed historically by the Department of Health over a number of years in response to a variety of needs and policy initiatives, for example, the Public Health Common Data Set, population health outcome indicators, Our Healthier Nation (OHN) indicators, clinical indicators, and others.
The compendium contains data on avoidable injury-related mortality and hospital admissions, including for example:
- Deaths within 30 days of emergency admission to hospital: fractured proximal femur
- Hospital episodes (admissions): Accidents
- Mortality from accidental falls
- Mortality from accidents
- Mortality from land transport accidents
The Health Survey for England
The Health Survey for England is s series of annual surveys about the health of people living in England. It covers adults aged 16 and over and children aged 2 to 15 years. The Survey began in 1991 and has been carried out annually since then (2004 results have recently been published). A number of core questions are included every year but each year’s survey also has a particular focus on a disease or condition or population group. Topics are brought back at appropriate intervals in order to monitor change.
The 'core' includes: questions on general health and psycho-social indicators, smoking, alcohol, demographic and socio-economic indicators, questions about use of health services and prescribed medicines and measurements of height, weight and blood pressure. Many of the surveys since 1993 have collected data on avoidable injury, however, detailed information was collected in in-depth avoidable injury modules in 1995, 1996 and 2001.
The “Health Survey for England Non-Fatal Accidents Report (2001)” gives findings of the most recent detailed avoidable injury data collection in 2001, and includes comparison with data collected in 1995 and 1996.
Up until 2003 the Department of Trade and Industry operated two linked databases: the Home Accident Surveillance System (HASS) and the Leisure Accident Surveillance System (LASS). The HASS and LASS databases recorded details of home and leisure accidents that were serious enough to cause an injury warranting a visit to hospital. Accidents where death occurred were excluded from this analysis (although different HASS and LASS data concerning fatalities were collected). The databases contained information from a sample of attendances at 18 Accident and Emergency (A&E) departments across the UK including age, gender, nature of injury, nature of accident, and product involvement.
Data were collected primarily to gain understanding of how, why and where home and leisure accidents occur and enable the development of effective consumer safety policies to prevent them in the future.
The DTI ceased collection of HASS and LASS statistics in 2003. The databases are now held by the Royal Society for the Prevention of Accidents (RoSPA). Reports based on historical data are available, and the databases can be independently searched and queried, but there is no ongoing data collection.
Road Traffic Accidents (STATS-19 Reports)
Road traffic collisions reported to the Police are recorded in STATS19 reports, currently held by the Department for Transport. The legal requirement on the reporting of road traffic collisions to the police is limited, and means that if details are exchanged at the scene of a collision, and the police do not attend, the event can go unrecorded. There is a substantial literature on the under-reporting, for this and other reasons, of road traffic accidents and injuries in the STATS19 reports and it has been suggested that 'slight' casualties are under-reported by a factor of 1.7, while 'serious' casualties are under-reported by a factor of 2.76. (Source: Roadpeace. Under-reporting of road traffic casualties in the UK. London: Roadpeace, 2001).
Fire Statistics and Research (Communities and Local Government)
The Fire Statistics and Research Division of Communities and Local Government (CLG) collect and analyse official statistics about the causes and injuries resulting from fire. Statistics are compiled on fires and deaths and other casualties resulting from fires based on returns provided by local authority Fire Brigades in the United Kingdom. Considerable detail is provided on fires in buildings, road vehicles or other types of property or involving casualties or rescues, including:
- cause of fire
- type and location of property
- source of ignition
- material first ignited or responsible for development of fire
- extent of damage caused
- age, sex of casualties
- nature of the injury
- time of day, period
- fire brigade area
- effectiveness of smoke alarms
- attendance times
- method of fire fighting (before and after brigade attendance)
- method of rescue
The main statistics are published annually in a Communities and Local Government Statistical Bulletin, but more detailed data are available on request, for which a charge may be made.
The Health & Safety Executive collect and collate data on work-related ill-health, injuries, dangerous occurrences and safety enforcement.
The main sources of data are:
- Reports made in compliance with the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR). The data are based on accident reports from employers and the self-employed to local authorities. The 1995 regulations updated previous legislation, which means that statistics from 1996/97 onwards are not directly comparable with previous years.
- Labour Force Survey (LFS) data on workplace injury. HSE placed a supplement of detailed questions on workplace injury in the 1990 LFS, and has placed a limited set of injury questions annually since 1993. The LFS gives estimates on the levels of workplace injury that are not subject to under-reporting, and together with the rates of reported injury, gives estimates of the levels of reporting of injuries in industries.
Trauma and Audit Research Network (TARN)
TARN aims to collect clinical and epidemiological data in order to provide a statistical base to support clinical audit, aid the development of trauma services and inform the research agenda.
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