Utility of routine data reporting injuries requiring hospitalisation in Nepal: A secondary data analysis

Pandey, Bidhya; Bray, Isabelle; Joshi, Sunil K; Mytton, Julie

Abstract

Background
Injuries are an important public health issue in Nepal, contributing significantly to both morbidity and mortality. There is no injury surveillance system available, however healthcare service use is routinely reported to central government using the Health Management Information System (HMIS). The study was conducted as part of a wider programme of research to explore the burden of injuries in nepal, funded by the UK National Institute for Health Research (Ref 16/137/49).
Objectives
To explore the utility of HMIS data to understand the burden of injuries in Nepal, inequalities by age and sex and changes over time.
Design
Secondary analysis of published data
Setting
Nepal
Data sources
We used published national HMIS data on hospitalised injuries in Nepal, between 2009/2010 and 2016/2017, classified using International Classification of Disease codes. We grouped codes to report data by injury type, using the Global Burden of Disease injury classification framework where possible. We calculated crude rates of total unintentional injuries and self-harm and crude rates by year for each type of unintentional injury, with correlation coefficients to describe any trends over time.
Results
The trend in crude unintentional injury rate increased over time. Road Traffic Injury (RTI) admissions increased from 4.28/100,000 (95% CI 4.03-4.52) population in 2009/2010 to 10.55/100,000 (95% CI 10.17 to 10.92) in 2016/2017 (r=0.93), while admissions following poisoning almost halved over the same period, from 7.52/100,000 (95% CI 7.19-7.84) to 3.62/100,000 (95% CI 3.40- 3.84) (r=-0.87). Inequalities by age and gender were noted; during the period 2014/2015- 2016/2017, admissions following RTI most commonly affected adults of working age (13.82/100,000; 95% CI 13.50 to 14.14), and were 1.78 times more common in men (13.63/100,000; 95% CI 13.27 to 13.99) than women (7.77/100,000; 95% CI 7.49 to 8.05).
Limitations
The coding and completeness of the injury data currently limit the utility of their use for monitoring and decision making.
Conclusions
The cause of injury admissions between 2009/2010 and 2016/2017 appears to have shifted over time, with trends varying by injury type. In the absence of an injury surveillance system, routine inpatient data collected through HMIS has the potential to inform policy and practice.
Future work
Support to enhance the completeness of data collection and accuracy and consistency of data coding has the potential enhance the utility of this existing data system.
Funding

• Journal Article Type: Article
• Acceptance Date: Jan 22, 2024
• Online Publication Date: May 22, 2024
• Deposit Date: Mar 24, 2024
• Publicly Available Date: Jun 5, 2024
• Journal: NIHR Global Health Research Journal
• Print ISSN: 2631-7605
• Electronic ISSN: 2631-7613
• Publisher: NIHR Journals Library
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.3310/ATAE3098
• Public URL: https://uwe-repository.worktribe.com/output/11841281