Linkage and concordance of trauma registry and hospital discharge records: lessons for occupational injury surveillance and research

OBJECTIVE: Occupational injury researchers typically use payer to identify work-related injuries in hospital discharge records. Many trauma registries contain a work-related field, independent of payer. Linked trauma registry and hospital discharge records were used to assess data field concordance and to assess the validity of using payer or external cause of injury (E-codes) to identify work-related injuries. METHODS: Washington State Trauma Registry records were linked to hospital discharges (year 2009). RESULTS: There was substantial agreement between Washington State Trauma Registry and hospital discharge records for workers' compensation as primary payer. E-code based methods of identifying occupational injuries had high specificity (more than 99%) but low sensitivity (less than 14%). Payer was 76% sensitive and 98% specific. CONCLUSIONS: This study found substantial agreement for data fields key to occupational injury surveillance and research. Nevertheless, many work-related injuries could not be identified using hospital discharge records