Currently, severity of injuries is estimated by police on the scene of a traffic crash. A simple rating scale is employed by many states or communities, i.e., the KABCO injury scale or a comparable version. The police officer codes the overall level of injury each person receives as killed, incapacitating, non-incapacitating, possible, or no injury. However, what the officer observes at a crash scene can differ substantially from what is found by medical personnel. The National Highway Traffic Safety Administration (NHTSA) facilitates the Crash Outcome Data Evaluation System (CODES). State CODES programs conduct a probabilistic matching of statewide health records with crash reports. However, a limited number of states are participating in this system, and the technical process is complex. Trying to connect police reports with any further medical outcome or cost data can be technically difficult. Also, organizational and other barriers may exist for making such linkages within states. NHTSA and the Governors Highway Safety Association recently developed a series of safety performance measures that include use of fatalities and serious non-fatal injuries. The American Association of State Highway and Transportation Officials has also been working to develop similar performance measures. If serious non-fatal injuries and crashes are to become major performance measures for states, then an accurate and feasible method for determining level-of-injury severity based on a medical assessment is needed.
The objectives of this research were to:
(a) Identify an injury scoring system for further consideration. Analyze the advantages and disadvantages of conventional injury scoring systems based on International Statistical Classification of Diseases and Related Health Problems (ICD) codes and KABCO. Document advantages and disadvantages of various definitions for a serious injury metric.
(b) Develop a roadmap to assist states in developing and implementing an interim system to measure and report injury severity using accepted injury scoring systems based on ICD codes.
(c) Expanding on (b), develop a state-based framework to perform comprehensive linkage of records related to motor vehicle crashes resulting in serious injuries, and incremental steps and priorities for achieving the linkage.