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Developing a National Injury Surveillance System
ARGENTINA
ICE on Injury Statistics Meeting
Cuernavaca, Mexico. 1-2 June 2005
Dr. Marta Vacchino. MSc Epidemiology
ANLIS-National Institute of Epidemiology Dr Juan H. Jara. Ministry of Health and Environment
e-mail: [email protected] [email protected]
Injury Surveillance System:
Sistema de Vigilancia de Lesiones por Causa Externa. (S.I.V.I.L.E)
Started: September 2003
System design and piloting: until March 2004
System entry and training: from April 2004
Working units: from October 2004
Evaluation: from June 2005
Injuries in the World,America and Argentina
PROPOSAL OF SENTINELUNITS
Descriptive epidemiologyTime, place, person
What is a surveillance system?
Presentation:Instrument for data collection
APPLICATION EXERCISES
TRAININGWORKSHOPS
Recall: Elements of a Surveillance System.
Health Care System Public Health Authority
Event Data
InformationIntervention(Feedback)
Reporting
Analysis & Interpretation
Expected changes
Expected changes
Decision
Developing a national injury surveillance system
Health Care System Public Health Authority
Data
Information
Reporting
HEALTH EVENT
Injuries: the physical damage
that results when a human body is suddenly subjected to intolerable levels of energy.
bodily lesion resulting from acute exposure to energy in amounts that exceed the threshold of physiological tolerance
or impairment of function resulting from a lack of one or more vital elements.
time between exposure and injury is short
Developing a national injury surveillance system
Health Care System Public Health Authority
Data
InformationIntervention
DATA SOURCE
Selected sites (sentinel approach)
Emergency Medical Services, pre-hospital emergency
Hospital emergency departments, hospital inpatient services
Mostly public sector. Voluntary entry
Sentinel Units. Components
Clinical
Epidemiological Statistic
Actions: filling questionnaire, injury diagnosis and treatment
Actions: filling questionnaire, injury diagnosis and treatment
Actions: localdata analysis andinterpretation,local dissemination
Actions: localdata analysis andinterpretation,local dissemination
Actions: data entry, help in data analysisand local resultdissemination
Actions: data entry, help in data analysisand local resultdissemination
Developing a national injury surveillance system
Health Care System Public Health Authority
Data
InformationIntervention
CASE DEFINITION Any person who demands assistance to
Sentinel Unit
for any type of injury, intentional or unintentional,
for all age groups, first visit for treatment of that injury. I.D.C-10 and ICECI recommendations
Developing a national injury surveillance system
Health Care System Public Health Authority
Event Data
InformationIntervention
Reporting frequency
Immediate
Web-based system
MinistryMinistryof Health and of Health and EnvironmentEnvironment
Peripheral levelHealth care systemSentinel Units
Central level
Developing a national injury surveillance system: Data flow
Developing a national injury surveillance system
Health Care System Public Health Authority
Event
Intervention
Data Analysis
It is automated
Data characteristics
Basic descriptive analysis, tables and graphs
Developing a national injury surveillance system
Health Care System Public Health Authority
Event
Intervention
Acceptability. Reliability (sensitivity and positive predictive value). Sustainability. Timeliness.
System Evaluation
Where we are today!!!Where we are today!!!
Sentinel Units: 52Sentinel Units: 52
República Argentina. May 2005República Argentina. May 2005
Where we are today!!!Where we are today!!!
Sentinel Units: 52Sentinel Units: 52
República Argentina. May 2005República Argentina. May 2005
Some JurisdictionsProvince of Buenos Aires
and Buenos Aires City
Phase 0 – No proposal
Phase I – Some proposal
Phase II - Received formative assessment
Phase III - Proof / PC/ Connection
Phase IV – System working
REFERENCES
strength government support
national coverage
sentinel approach
reliable and valid data
on line system
weaknessmeasure trends
must define different unit profiles
not easy to do extrapolations
opportunityvoluntary entry
motivated recorders
threat lack of human resources
work overload
Challenges !! : SWOT MATRIXChallenges !! : SWOT MATRIX
