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Show Utah CODES Project: 1992 - Present Lawrence J. Cook, M.Stat. Abstract Motor vehicle crashes are the leading cause of injury death in the United States for people aged one to 34 years. Using probabilistic linkage, Utah CODES has combined motor vehicle crash data to healthcare databases, making it possible to evaluate the effect of crash variables on health outcomes. To date, researchers at Utah CODES have studied the effect of improper seatbelt use on hospitalizations, older and younger drivers, specialized vehicles such as all terrain vehicles and snowmobiles, and drivers with specific medical conditions. The results of this research have been used to support traffic safety programs and legislation, presented at national meetings, and published in peer-reviewed journals. Motor vehicle crashes are the leading cause of injury death for people aged one to 34 years (NCHS, 1998). Each year, over 40,000 people die in a motor vehicle crash in the United States and another 3.5 million suffer nonfatal injuries (NCHS, 1998; Quinlan et al., 1999). Utah's 2000 death rate from motor vehicle crashes of 16.7 deaths per 100,000 population is higher than the national average of 14.9 deaths per 100,000 population. Both of these rates are higher than the goal of 9.0 deaths per 100,000 population outlined in Healthy People 2010 (U.S. Department of Health and Human Services, January 2000). Utah's nonfatal injury rate for motor vehicle crashes, 1,347 per 100,000 population, is higher than the death rate. Motor vehicle crash injuries may require treatment at the scene by emergency medical services, at an emergency department, or result in the person being admitted as an inpatient to the hospital. For this reason the National Highway Traffic Safety Administration (NHTSA) funded Utah, along with six other states, to conduct probabilistic record linkage, a method for combining databases, to study motor vehicle crashes in conjunction with other healthcare databases. This project, known as the Crash Outcome Data Evaluation System (CODES) not only demonstrated the feasibility of probabilistic record linkage using large, statewide databases, but also quantified the risk of not wearing a seatbelt as it pertains to being treated by emergency medical services, treated at the emergency department, admitted to a hospital, and killed as a result of a motor vehicle crash (Johnson and Walker, 1996). Since 1992 NHTSA has funded CODES projects in 26 states. The availability of statewide, population-based datasets is a major strength of the Utah CODES project. The Utah CODES project is based at the Intermountain Injury Control Research Center, University of Utah School of Medicine and is directed by J. Michael Dean, M.D., M.B.A. and Larry Cook, M.Stat. Background When first funded in 1992, the Utah CODES project used four 1991 population-based databases: motor vehicle crash records, completed by police officers at the scene, collected by Utah Department of Transportation (UDOT); emergency medical services runs collected by the Utah Department of Health, Bureau of Emergency Medical Services; emergency department and hospital discharge records collected originally from individual hospital organizations. Included in the motor vehicle crash database are several variables that are of interest for motor vehicle crash analysis, including the time of day of the crash, weather conditions, type of crash, how many people and vehicles are involved, speed of each vehicle involved, ages of each participant, passenger seating location in the vehicle, and seatbelt use information for each passenger. A police assessed injury score called KABCO is assigned to each passenger at the scene of the crash. However, research has shown that KABCO scores are an unreliable measure for assessing injury severity (Agran, Castillo and Winn, 1990). More accurate measures of severity exist (i.e., ones calculated from medical information) in other healthcare databases including Glasgow Comma Score (GCS) assessed by emergency medical services, and Abbreviated Injury Score (AIS) and Injury Severity Score (ISS) calculated from emergency department and hospital discharge datasets. While there are injury mechanism codes in the healthcare databases to identify motor vehicle crashes, they include none of the crash characteristics 20 Utah's Health: An Annual Review Volume VIII |
