Injuries

DEFINITIONS

Average annual population — half the sum number of the population at the beginning and the end of the year. This index is used to calculate rates.

External cause — outer environmental factors, events and circumstances which have caused the injury or poisoning. External causes are classified on the basis of Chapter XX (V01–Y98) of ICD-10.

Health Information System — a database belonging to the State Information Systems where the data related to health care are processed for entry into and performance of contracts for the provision of health services, for guaranteeing the quality of health services and the rights of patients and for the protection of public health, including for maintaining registers concerning the state of health and for the management of health care (Health Services Organisation Act, §591 section 1).

ICD-10 — International Statistical Classification of Diseases and Related Health Problems 10th Revision (see classifications).

Injury — damage to the body caused by external force. Covers injuries, poisonings, and certain other consequences of external causes. Injuries are classified on the basis of Chapter XIX (S00–T98) of ICD-10.

Injury case — injury or injuries caused by certain external cause.

Main diagnosis — the cause for treatment. Coded according to ICD-10.

Place of residence — the county according to the population register. It is classified according to the Classification of Administrative and Settlement Units of Estonia (EHAK) (see classifications). Until 2017, data by the counties is distributed by the administrative division that existed before administrative reform (October 2017). Data starting from 2018 is distributed by new administrative division. "Estonia" does not include cases for which the person’s residence is unknown or his or her residency is marked as residence outside of Estonia. These are provided separately.

Treatment need — in statistics, all injuries that were a cause for visiting health care service provider, are counted as injuries that needed treatment.

METHODOLOGY

Data

Injury statistics is based on treatment invoices delivered by health care service providers, who are contract partners of Estonian National Insurance Fund, to National Insurance Fund during the corresponding year. All treatment invoices for outpatient and inpatient care, day care, rehabilitation, nursing, and dental care which have main diagnosis of S00–T98 (according to ICD-10) are covered.

Injury cases of people both with and without health insurance are covered in statistics. The dataset for 2016 did not include age for uninsured people. To reduce the loss of data, information from treatment invoices was linked to Health Information System data through other characteristics. The age for 66% of the uninsured people was therefore identified.

Statistics does not include injury cases registered in Defense Forces or in prisons, or those injuries that were treated by ambulance on site and the patient was not transferred to hospital.

Coding injuries

The main diagnosis is coded according to Chapter XIX of ICD-10. Three first digits of the main diagnosis are taken into account, which indicate the injured body part and the type of injury.

Three first digit of ICD-10 external cause of the injury code are taken into account, which indicate the direct cause of the injury.

According to ICD-10, a five-digit code should be used to describe an external cause of an injury:

The place of occurrence described on the basis of ICD-10 codes:

Code of place
of occurrence
(ICD-10)
Place of occurrence
0 Home
1 Residential institution
2 School, other institution and public administrative area
3 Sports and athletics area
4 Street and highway
5 Trade and service area
6 Industrial and construction area
7 Farm
8 Other specified places
9 Unspecified place

If the external cause is not registered or there have been registered several external causes belonging to different categories for that case (eg., W01 and W22) then the case is under “External cause unknown“, “External cause unknown, main diagnosis T78“ or “External cause unknown, main diagnosis T79–T98“. External cause is also counted as unknown if external cause is Y90–Y98 which, according to ICD-10, is not allowed to use as the only external cause of injury.

Injury cases

There can be several treatment invoices for one injury case from different health care service providers. In statistics, injury cases are obtained by linking person-based treatment invoices.

Treatment invoices for one person are counted as belonging to one injury case according to the following principles:

Cases with main diagnosis of injuries and poisonings (S00–T75), adverse effects not elsewhere classified (T78), and complications and sequelae of injuries, poisonings and other consequences of external causes (T79–T98) are treated as separate cases. The main diagnosis on treatment invoice is taken into account when identifying the cases.

The occurrence of one case more than once in statistics cannot be excluded due to coding errors. Some cases of certain injuries, which can occur repeatedly during a year (eg,. alcohol toxication, foreign body in the eye), could have been left out from statistics, because the methodology used did not allow to distinguish between all the treatment invoices connected to separate cases.

In table VIG12, cases that occurred at home, at other places, and cases for which the place of occurrence is unknown, are distinguished. "Other places" covers codes 1–8. The place of occurrence is unknown if place is coded as "unspecified place" or the place is not registered.

Statistics include injury cases that needed treatment during the year, not only new cases, because treatment invoices delivered during one year are used for statistics and the statistical type (new or old case) of main diagnosis is not always marked correctly.

The data are published in absolute and relative numbers (rate per 100 000 inhabitants).

In tables VIG13 and VIG14 every person is counted once for one category of external causes, regardless of the number of injury cases during the year.

CLASSIFICATIONS

Classification of Administrative and Settlement Units of Estonia (EHAK)

This classification is used upon submission of regional statistics. Regional health care statistics are submitted by 15 counties. Until 2017, data by the counties is distributed by the administrative division that existed before administrative reform (October 2017). Data starting from 2018 is distributed by new administrative division. This classification system is available in Estonian on the webpage of the Statistics Estonia in the Classifications section.

The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)

This classification is used to code diagnoses and submit the data about disease cases in accordance with the diagnoses. The classification system is available on the webpage of the World Health Organization.

PUBLICATIONS

Panov L. Vanemaealiste vigastused 2016–2020. Tallinn: National Institute for Health Development, 2022. The analysis in Estonian can be found here (summary in English)

Panov L. Injuries in Estonia 2017. Tallinn: National Institute for Health Development, 2018. The analysis can be found here

National Institute for Health Development. Vigastused Eestis 2016. Injuries in Estonia 2016. Tallinn: National Institute for Health Development; 2017. The publication can be found here

CONTACT

Liina Veskimäe

Department of Health Statistics

National Institute for Health Development

E-mail: Liina.Veskimae@tai.ee

 

Updated: 29.04.2022