How representative is the Victorian Emergency Minimum Dataset (VEMD) for population-based injury surveillance in Victoria? A retrospective observational study of administrative healthcare data

• Published in: BMJ open Vol. 12; no. 12; p. e063115
• Main Authors: Rezaei-Darzi, Ehsan, Berecki-Gisolf, Janneke, Fernando, Dasamal Tharanga
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 14.12.2022; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: Age groups; Codes; Datasets; Delivery of Health Care; Emergency medical care; Emergency Medical Services; Emergency Service, Hospital; epidemiology; Health care policy; Health insurance; health policy; Health Services Research; Hospitalization; Hospitals; Humans; Injuries; Male; Medicare; Middle Aged; Morbidity; Mortality; Observational studies; Patient admissions; Population-based studies; public health; Retrospective Studies; Surveillance; Trauma; Australia; epidemiology; public health; health policy
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2022-063115

ObjectiveThe Victorian Emergency Minimum Dataset (VEMD) is a key data resource for injury surveillance. The VEMD collects emergency department data from 39 public hospitals across Victoria; however, rural emergency care services are not well captured. The aim of this study is to determine the representativeness of the VEMD for injury surveillance.DesignA retrospective observational study of administrative healthcare data.Setting and participantsInjury admissions in 2014/2015–2018/2019 were extracted from the Victorian Admitted Episodes Dataset (VAED) which captures all Victorian hospital admissions; only cases that arrived through a hospital’s emergency department (ED) were included. Each admission was categorised as taking place in a VEMD-contributing versus a non-VEMD hospital.ResultsThere were 535 477 incident injury admissions in the study period, of which 517 207 (96.6%) were admitted to a VEMD contributing hospital. Male gender (OR 1.13 (95% CI 1.10 to 1.17)) and young age (age 0–14 vs 45–54 years, OR 4.68 (95% CI 3.52 to 6.21)) were associated with VEMD participating (vs non-VEMD-participating) hospitals. Residing in regional/rural areas was negatively associated with VEMD participating (vs non-VEMD participating) hospitals (OR=0.11 (95% CI 0.10 to 0.11)). Intentional injury (assault and self-harm) was also associated with VEMD participation.ConclusionsVEMD representativeness is largely consistent across the whole of Victoria, but varies vastly by region, with substantial under-representation of some areas of Victoria. By comparison, for injury surveillance, regional rates are more reliable when based on the VAED. For local ED-presentation rates, the bias analysis results can be used to create weights, as a temporary solution until rural emergency services injury data is systematically collected and included in state-wide injury surveillance databases.