MVCs cost Nebraska $1.6 billion a year. MVCs are the leading cause of injury death

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2 MVCs cost Nebraska $1.6 billion a year MVCs are the leading cause of injury death MVCs are the 4th leading cause of injury hospital treatment in the state Nebraska CODES Injury Surveillance: Vehicle Crash and Safety Reports, Nebraska Department of Health and Human Services, Division of Public Health.

3 Contribu)ng Factor Of all persons involved in a MVC N=69,185 Of all persons involved in an injury MVC N=15,506 Distracted Driving 7% 5% Adverse Weather 2.5% 3.1% Driving Under the Influence 1.4% 1.7% Speeding < 1% 1.5% Nebraska Crash Outcome Data EvaluaJon System. Motor Vehicle Crash Outcomes in Nebraska: 2012 Management Report Police Crash Reports

4 Top 5 Drivers Contribution Factors for MVC Number of MVCs on the Day of First Snow, Nebraska, Nebraska, 2006 to 2010: 15% of crashes occurred under adverse weather condi)ons 51% occurred under snowy/ icy weather related condi)ons Source: Nebraska DHHS CODES

5 Inform road weather management strategies Source: U.S. Department of Transportation, Federal Highway Administration

6 Inform law enforcement strategies for special events Source: U.S. Department of Justice, Office of Community Oriented Policing Services

7 To demonstrate the value of ED syndromic surveillance (SS) data to aid the surveillance of MVC related injuries in Nebraska.

8 Source:

9 Data Set Timeliness Data Source Data Elements ED SS 22 hours Hospital EHR Department AddiJonal informajon not collected in the UB 04 form: Chief Complaint Death Cer)ficate Trauma Registry* 24 hours Nebraska Office of Vital StaJsJcs U.S. Standard Death CerJficate 1 month Trauma Registry NaJonal Trauma Data Standard (NTDS) with addijonal State required elements EMS 3 months EMS NEMSIS V. 2 Statewide Crash Reports HDD CODES Linked Data months months Police Crash Reports compiled at the Nebraska Department of Roads Hospital Billing Department 24 months Death CerJficate, EMS, HDD, and Statewide Crash Reports MMUCC v. 1 (Model Minimum Uniform Crash Criteria) Clinical and demographic; Limited to UB 04 claim form requirements

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12 Completeness Consistency

13 Data Element Facility Identifier Admission Date Patient ID Patient Visit ID Patient Age Patient Gender Patient Zip Code Chief Complaint Primary ICD9 DX Secondary ICD9 DX Code 1 % of Completeness 82% 67% Required data elements Data quality assessed by calculating percentage completeness of relevant data elements

14 Data Element Facility Identifier Admission Date Patient ID Patient Visit ID Patient Age Patient Gender Patient Zip Code Chief Complaint Primary ICD9 DX Secondary ICD9 DX Code 1 % of Completeness 87% 74% Required data elements Data quality assessed by calculating percentage completeness of relevant data elements

15 Number of weekly ED visits due to MVC- related injury Hospital A Douglas County, r = 0.75 Number of MVC- related injuries Jan Jan Feb Feb Mar Mar Apr Apr May May May Jun Jun Jul Jul Aug Aug Sep Sep Oct Oct Oct Nov Nov Dec- 11 week star)ng date MVC_SS MVC_HDD

16 Number of weekly ED visits due to MVC- related injury Hospital A Douglas County, Number of MVC- related injuries r = Mar Mar Mar Apr Apr Apr Apr Apr May May May May Jun Jun Jun Jun Jul Jul Jul Jul Jul Aug Aug Aug Aug Sep Sep Sep Sep Sep Oct Oct Oct Oct Nov Nov Nov Nov Dec Dec Dec Dec- 12 week star)ng date MVC_SS MVC_HDD

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18 Percentage of weekly ED visits due to MVC- related injury Hospital A Douglas County, 2011 %MVC- related injuries 10% 9% 8% Snow Snow (9 ), heavy (9 max), fog, heavy haze, fog, hail, haze, Omaha Beer Fest Omaha Beer Fest freezing hail, rain, freezing blowing rain, snow blowing snow 7% Snow (13 max), heavy freezing fog, Annual Taste blowing Snow snow, (13 haze, max), glaze heavy or freezing rime fog, Annual Taste of Omaha of Omaha blowing snow, haze 6% NCAA College Cinco de Mayo Word NCAA Series College Cinco de Mayo 5% Word Series 4% 3% 2500 Rain (0.4 max), Rain heavy (0.4 ), fog heavy fog Snow (1.3 max), rain Snow (1.3 (1 max), fog, rain thunder (1 max), fog, thunder 2000 Balloon & Wine Balloon & Fes)val Wine Snow (7 max), Snow (7 max), Fes)val freezing fog, freezing fog, heavy fog heavy fog MAHA 1500 Music River City Rodeo & MAHA Music River City Rodeo & Fes)val Douglas County Fair Fes)val Douglas County Fair 1000 Number of weekly ED visits 2% 500 1% 0% 9- Jan Jan Feb Feb Mar Mar Apr Apr May May May Jun Jun Jul Jul Aug Aug Sep Sep Oct Oct Oct Nov Nov Dec week star)ng date Weekly visits_ss %MVC_SS Mean percent MVC- related injuries: 2% (range: %)

19 Percentage of weekly ED visits due to MVC- related injury Hospital A Douglas County, % 2500 % MVC- related injuries 9% 8% 7% 6% 5% 4% 3% Rain (0.3 max) Cinco de Mayo Fog, thunder, hail, haze Annual Taste of Omaha; Omaha Beer Fest NCAA College World Series; fog, rain (3 max) Balloon and Wine Fes)val Rain (0.3 max), fog, thunder, hail MAHA Music Fes)val River City Rodeo & Douglas County Fair Rain (0.2 max),haze Snow (8 max), freezing rain Number of Weekly ED visit 2% 500 1% 0% 11- Mar Mar Apr Apr May May Jun Jun Jul Jul Jul Aug Aug Sep Sep Oct Oct Nov Nov Dec Dec week star)ng date Weekly visits_ss %MVC_SS Mean percent MVC- related injuries: 2% (range: %)

20 Percentage of weekly ED visits due to MVC- related injury Hospital A Douglas County, % 4000 Cinco de Mayo % MVC- related injuries 5% 4% 3% 2% Ice on road Snow (9 max), blowing snow, fog, haze, glaze or rime, sleet, Omaha Beer Week Rain, May (1.5 max) Fog, rain (1.5 max) Omaha Beer Fest; Fog, rain (1 max) Annual Taste of Omaha NCAA College World Series Balloon & Wine Fes)val MAHA Music Fes)val Fog, rain (1 max); STIR concert series Snow (8 max), fog, glaze or rime River City Rodeo & Douglas County Fair Number of weekly ED visits % 500 0% 30- Dec Jan Jan Feb Feb Mar Mar Apr Apr May May Jun Jun Jun Jul Jul Aug Aug Sep Sep Oct Oct Nov Nov Dec Dec week star)ng date Weekly visits_ss %MVC_SS Mean percent MVC- related injuries: 1% (range: %)

21 Percentage of weekly ED visits due to MVC- related injury Hospital A Douglas County, % 3000 %MVC- related injuries 9% 8% 7% 6% 5% 4% 3% Snow (1 max); Ice on road Snow (5 max); Wind ~70mph Ice on road Snow (4 max) Omaha Beer Week Snow (1 max); Wind ~70 mph Snow; Rain (1 max); Hail Rain (2 max); Slick road Cinco de Mayo Rain (3 max); hail, flash floods Rain (7 max); flash floods Omaha Beer Fest Annual Taste of Omaha NCAA College World Series Balloon and Wine Fes)val MAHA Music Fes)val River City Rodeo & Douglas County Fair Snow (2 max) Snow (2 max) Number of weekly ED visits 2% 500 1% 0% 29- Dec Jan Jan Feb Feb Mar Mar Apr Apr May May Jun Jun Jun Jul Jul Aug Aug Sep Sep Oct Oct Nov Nov week star)ng date Weekly visits_ss %MVC_SS Mean percent MVC- related injuries: 1.6% (range: %)

22 Significant correlajons were detected between SS ED and ED HDD The analysis of the SS ED data indicates a possible temporal trend in the incidence of MVC- related injuries in NE There is a possible associajon between weather and entertainment events and spikes in MVC- related injury

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24 MVC- related injury in SS ED data is highly correlated with ED HDD SS ED data can be used for the Jmely idenjficajon of MVC- related injuries in Nebraska

25 QuanJfy the burden of weather related MVC by locajon of the incident and other relevant variables Improve methods to combine SS, EMS and public safety informajon to idenjfy MVC hot spots

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