BACKGROUND: Work-related injuries that require immediate hospitalization are severe, costly, and often disabling injuries. Currently both Washington State’s Division of Occupational Safety and Health and the Federal Occupational Safety and Health Administration require employers to report workplace injuries resulting in inpatient hospitalizations. Several existing Council of State and Territorial Epidemiologists (CSTE) Occupational Health Indicators (OHI) use hospital data (Indicators 2, 6, 9, 20, 22). However, the work-related hospitalizations indicator (2) does not discriminate between immediate and later admissions (for progressive or chronic conditions or follow-up care), as hospital discharge records rarely capture the date of injury but instead include only the admission date; other indicators are limited to specific diagnoses. We aim to describe the development of a unique surveillance system in Washington State created by linking hospital discharge data to workers’ compensation (WC) records to identify immediate inpatient hospitalizations.
METHODS: The immediate inpatient hospitalization system links accepted WC claims data to hospital discharge data to identify and characterize inpatient hospitalizations within 1 day of work injury. Hospital discharge data are obtained quarterly (defined by date of discharge) for inpatient hospitalizations in WA hospitals, for patients 14 years of age or older. Records were linked based on name (last, first name or initial, middle), birthdate, workers’ compensation injury date within one day of hospital admission date, sex, and worker’s residence zip code; the dataset was limited to one discharge per claim (earliest admission).
RESULTS: In 2014, there were 668 immediate work-related inpatient hospitalizations in WA (linked to WC), with differences in distribution by age/gender; of these 253 claims were considered ‘catastrophic’ (an inpatient acute-care hospital stay of 4 or more days). The Construction industry had the largest percentage of claims (22%). The most common accident type was ‘Falls’ (38%), and the most common nature of injury was “fractures” (53%). Hospitalizations peaked in the third quarter of the calendar year.
CONCLUSIONS: The high proportion of traumatic injuries in immediate inpatient hospitalizations exemplifies how this data differs from other measures of work-related injuries including hospitalizations that do not differentiate by immediacy of admission (which often include a large percentage musculoskeletal disorder admissions). The immediate inpatient work-related hospitalization surveillance system provides descriptive data regarding high risk industries, and results can be used to inform prevention efforts, to monitor trends over time and to evaluate employer compliance with reporting regulations. We do not know of a comparable surveillance system currently operating in the US.