• Nurturing public understanding and support: Broadening public understanding of the feasibility and value of efforts to prevent and ameliorate injuries and promoting investment in injury prevention by managed care organizations.

  • Promoting informed policy making: Improving the information systems used for identifying and evaluating injury risks and setting priorities for research and intervention.

SURVEILLANCE AND DATA NEEDS

Surveillance data are needed at the national, state, and local (community) levels. National data are critical for drawing attention to the magnitude of an injury problem, for monitoring the impact of federal legislation, and for examining variations in injury rates by region of the country and by rural versus urban or suburban environments. They are also useful in aggregating sufficient numbers of rare cases of a particular type of injury to identify patterns and mechanisms of injury. State and local data better reflect injury problems in specific communities and are therefore more useful in setting program priorities and evaluating the impact of local policies and expenditures.

As the availability, accessibility, and quality of the data have improved, they have played an increasingly important role in the development and evaluation of interventions at national, state, and local levels. However, significant impediments to effective injury surveillance remain, notably the high costs of development and maintenance of surveillance systems. Therefore, priority attention should be given to the improvement or expansion of existing data systems and to the development of efficient strategies for linking data across systems to gather additional and more complex information. Additionally, surveillance systems are dependent upon the quality of coded data.

The committee recommends that a high priority be directed at ensuring uniform and reliable coding of both the external cause and the nature of the injury using the International Classification of Diseases (ICD) on all health systems data, particularly on hospital and emergency department discharge records. Special efforts should be directed at training to ensure optimal use of the tenth revision of the ICD.

An important source of information on product-related injuries is the National Electronic Injury Surveillance System (NEISS) maintained for 25 years by the Consumer Product Safety Commission (CPSC). NEISS obtains statistical information through surveillance of 101 hospital emergency departments and through follow-up studies. The committee believes that an expansion of NEISS data collection to include all injuries treated in emergency departments will increase knowledge of the causes and severity of nonfatal injuries. Furthermore,



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