Cost estimates for statewide reporting of injuries by E coding hospital discharge abstract data base systems

A key element in the study of trauma problems is the design and development of adequate and affordable surveillance systems. One proposed method is the use of data available from hospital discharge abstract data base systems. However, surveillance systems based on existing data bases usually do not include codes that can identify the external causes of injuries, a critical limitation of the ability to determine the mechanisms of injuries. One obstacle to adding external cause of injury codes, known as E codes under the International Classification of Diseases, to uniform hospital discharge abstract data base systems is the cost of such a change. This study provided an estimate of the type and size of the costs for one State, based upon a survey of hospitals, information system vendors, and medical records experts. Two categories of the costs involved in adding E codes to hospital discharge abstract data base systems were identified. One-time implementation costs, which include modification of the computerized data base and the coding guidelines used by medical record personnel, average $600 per hospital. Annual costs resulting from increased operating expenses to include E codes average about $600 per hospital, because of the increased workload of coding and entry of the additional data. Adding E codes to hospital discharge abstract data base systems appears to be financially feasible for statewide surveillance of serious injury.