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Injury surveillance in children--usefulness of a centralised database of accident and emergency attendances
Insights
A centralized injury database effectively monitors childhood injury reduction targets. Proximity to emergency services influences overall and home injury visits, but not fractures, suggesting its utility for severe injury surveillance.
Area of Science:
- Public Health
- Epidemiology
- Injury Prevention
Background:
- Childhood injuries pose a significant public health challenge.
- Monitoring progress towards national injury reduction targets is crucial for effective intervention.
Purpose of the Study:
- To evaluate the utility of a centralized injury database for tracking progress on national childhood injury reduction goals.
- To identify factors influencing emergency department attendance for childhood injuries.
Main Methods:
- Analysis of a centralized injury database in West Glamorgan, Wales, covering 370,000 individuals.
- Inclusion of all first attendances for new injuries in children aged 0-14 years in 1993.
- Subgroup analysis for home injuries and fractures, with regression analysis against distance, car ownership, and deprivation indices.
Main Results:
- 10,117 injury attendances recorded (182/1000 children).
- Shorter travel distance to emergency departments correlated with higher overall and home injury attendances.
- No significant association found between travel distance and fracture injuries, car ownership, or deprivation indices.
Conclusions:
- Centralized injury databases are valuable for monitoring severe childhood injuries and progress towards national reduction targets.
- Proximity to emergency services is a key factor for overall and home-related injury visits.
- The lack of socioeconomic association with severe injuries may necessitate reassessment of national reduction targets and resource allocation strategies.
Objective:
To assess the usefulness of a centralised injury database in monitoring progress towards nationally set health targets for the reduction of childhood injuries.
Setting:
West Glamorgan County, Wales.
Methods:
Analysis was undertaken of data held in the West Glamorgan injury database which amalgamates population data with data from the three hospital units covering a population of 370,000. All first attendances due to a new injury in children aged 0-14 occurring in 1993 were analysed, with subgroup analysis for injuries occurring in the home and injuries resulting in fractures. Standardised injury ratios were compared with the distance travelled, car ownership, and Townsend index of deprivation at the ward level, using multiple linear regression.
Results:
A total of 10,117 first time visits due to injuries were recorded, representing a rate of 182 injuries/1000 children aged 0-14 in West Glamorgan County. Distance from home to the accident and emergency departments was inversely correlated with total injury attendances, and injuries occurring at home, but not with injuries resulting in fractures. Visit rates for any type of injury were not associated with local car ownership rates or deprivation indices.
Conclusions:
Proximity to accident and emergency departments is a strong determinant of the use of the service by children with overall injuries, and injuries occurring at home. The lack of a significant association between travel distance and injuries resulting in fractures suggests that it is more meaningful to use a centralised database of accident and emergency department attendances to monitor the more severe spectrum of childhood injuries in assessing progress towards national targets for their reduction. The absence of an association between severe injuries and local socioeconomic factors suggests that national targets for the reduction of socioeconomic differentials in childhood injuries may need to be reassessed. These databases are also useful in generating information to direct preventive strategies and to target resources to areas of greatest need.