About VISU data: sources and injury definitions

VISU holds de-identified data for Victoria on injury deaths, hospital admissions and Emergency Department (ED) presentations. Data are held on three separate datasets - they are not linked. Death data are supplied by the Australian Bureau of Statistics (ABS). Hospital admissions and emergency department presentations data are supplied by the Department of Health.

You can request data and information by filling in the data request form.

Datasets held by VISU

Level of injury severity	Source	No. of cases (2011)
Deaths	Australian Bureau of Statistics - Death Unit Record 1970, 1975, 1980, 1985, 1990-2006	165,697
Hospital admissions	Victorian Admitted Episodes Dataset Public hospitals from 1987/88-2009/10 Private hospitals from 1994/95-2009/10	3,450,541
Hospital emergency department presentations	Victorian Emergency Minimum Dataset from October 1995 to December 2010 The 38 Victorian public hospitals with 24-hour ED	3,811,967

Injury definitions

Injury is commonly defined as ‘any unintentional or intentional damage to the body ... caused by acute exposure to physical agents such as mechanical energy, heat, electricity, chemicals, and ionizing radiation interacting with the body in amounts or at rates that exceed the threshold of human tolerance'.

An unintentional injury is an injury that is unintended. It is often described as an accident. We try to avoid using the term ‘accident' as it implies that injuries are random events due to chance.

An intentional injury is an injury as a result of intended acts by people. That is, harm of one person by another (assault, homicide, neglect) or self-harm.

An injury death is defined as an injury or poisoning by an external cause (transport crash, fall, suicide, drowning etc.) that results in a person dying either in or out of hospital. In Victoria (and in other Australian states and territories) all deaths by external causes must be reported to the state coroner.

An injury hospital admission is defined as an injury or poisoning that results in the person being admitted to an inpatient bed (a ward, short stay observation unit, emergency medical unit, medical assessment and planning unit, intensive care bed, mental health bed or coronary care unit) and subsequently discharged alive either on the same day (after at least four hours from the time patient management begins) or after one or more nights stay in a hospital bed.

An injury emergency department (ED) presentation is defined as an injury or poisoning that results in a person presenting to a hospital emergency department for treatment who is triaged (assessed for urgency), including those patients who leave before treatment commences. A non-admission is a person who is discharged from the ED within four hours of the time patient management commences.

A child is usually defined as a person aged 0-14 years. An adult is usually defined as a person aged 15 years and older. These definitions apply because age data are usually grouped into five-year age groups (0-4, 5-9, 10-14, 15-19 etc.).

About the datasets

Deaths 

Source: Australian Bureau of Statistics (ABS) Death Unit Record File (ABS-DURF)

Victorian injury death records are supplied to VISU by the ABS from their mortality unit record data collection merged with the VISU-held ABS-DURF (injury deaths) dataset. The ABS sources their death data from deaths registrations administered by the various state and territory registrars of births, deaths and marriages. It is a legal requirement of each state and territory that all deaths are registered.

As part of the registration process, information on the cause of death is either supplied by the medical practitioner certifying the death on a Medical Certificate of Cause of Death, or supplied as a result of a coronial investigation. Data in the Causes of Death (COD) collection include demographic items, as well as Causes of Death information, that are coded according to the WHO International Classification of Diseases (ICD): Ninth Revision (ICD-9) from 1979 to 1996 or Tenth Revision (ICD-10) from 1997 onwards. The external causes chapters of ICD 9 and ICD 10 describe the causes of injury, poisoning and adverse events (complications of medical and surgical care). Deaths due to adverse events are not usually included in VISU reports.

Causes of Death data are published annually by the ABS and released within 15 months of the end of the reference period. For example, 2006 Causes of Death data were released on 14 March 2008. (VISU may receive the unit record file of injury and poisoning deaths 3-6 months later than the release date due to the time taken to prepare requested unit record file for release.) For VISU reports, deaths are almost always selected by year of death, not year of death registration (a small number of deaths are registered in the year following the year in which they occurred).

VISU holds unit record data on injury deaths (deaths due to external causes) for 1970, 1975, 1980, 1985, 1990-2006. There has been a delay in the supply of Victorian death data for 2007-9 but these years should be available in early 2012. 

ABS-DURF data items held by VISU

Demographic and administrative items

• Age, sex, local government area of residence
• Country of birth
• Date of death

Injury surveillance items

Multiple ICD-10 codes from any or all of the chapters of the ICD-10 manual can be assigned to each death record.

• Underlying cause of death - transport, fall, poisoning etc.

[Coded to ICD-10 Chapter XX: External Causes of Morbidity and Mortality (V01-Y34)]

• Associated causes - includes all other causes and conditions reported on the death certificate from any chapter of ICD-10.

These codes are then used to derive the following injury surveillance variables that are added to the VISU-held ABS-DURF dataset:

• Place of occurrence (location of injury) - home, road, street or highway etc. [Coded to ICD-10 Place of occurrence codes]
• Human intent - unintentional; intentional-assault, neglect, self harm; undetermined intent. Intent information is derived from the external cause of injury code.
• Injury diagnosis (specific injury code) - superficial injury of scalp, fracture of neck of femur etc. (Coded to ICD-10 Chapter 19 Injury, Poisoning and Consequences of External Cause S00-T98)
• Body region injured - head, thorax, shoulder, upper arm etc. Body region information is derived from the injury diagnosis variables.
• Nature of main injury - open wound, fracture, dislocation/sprain/strain etc. Nature of main injury is derived from the injury diagnosis variables.

Hospital admissions 

Source: Victorian Admitted Episodes Dataset (VAED)

Hospital admissions for injury and poisoning that contain an external cause code are extracted from the VAED (formerly the VIMD) by the Victorian Department of Health (DH) and supplied in de-identified unit record format to VISU every six months. The file is cleaned, checked and merged with the VISU-held VAED dataset.

From July 1998 cases recorded on the VAED are coded to ICD-10-AM-the WHO International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification. The Australian Modification of ICD-10 has been developed by the National Centre for Classification in Health (NCCH) at the University of Sydney with assistance from clinicians and clinical coders to ensure that the classification is current and appropriate for Australian clinical practice. The Australian Modification of ICD-10 is updated every two years and the development of ICD-11 (due 2015) is in progress. Up to June 30, 1998, cases were coded to ICD-9-CM.

The external causes chapters of ICD-9-CM and ICD-10-AM describe the causes of injury, poisoning and adverse events (complications of medical and surgical care). Adverse events and sequelae (late effects) of external causes of morbidity and mortality are usually not included in VISU reports.

VAED (hospital admissions) data items

Patient demographic and administrative items

• Age, sex, postcode, suburb and local government area of residence
• Country of birth
• Date of admission, date of separation (discharge) and length of hospital stay (in days)
• Separation type (patient destination on discharge from hospital): separation and transfer to acute hospital/extended care, death, separation to private residence/accommodation, separation and transfer to aged care residential facility, separation and transfer to mental health residential facility etc.

Injury surveillance items

Up to 40 ICD-10-AM codes from any or all of the chapters of the ICD-10-AM manual can currently be assigned to each record. These codes are then used to derive the following injury surveillance variables that are added to the VISU-VAED dataset.

• Cause of injury - transport, fall, poisoning etc.

[Coded to ICD-10-AM Chapter XX: External Causes of Morbidity and Mortality (V01-Y34)]

• Place of occurrence (location of injury) - home, road/street/highway etc. [Coded to ICD-10-AM Chapter XX: External Causes of Morbidity and Mortality (Y92.0-Y92.9)]
• Activity when injured - sports, leisure, work etc.

[Coded to ICD-10-AM Chapter XX: External Causes of Morbidity and Mortality (U50-U73)]

• Human intent - unintentional; intentional-assault, neglect, self harm; undetermined intent. Intent information is derived from the external cause of injury code.
• Injury diagnosis (specific injury code) - superficial injury of scalp, fracture of neck of femur etc. (Coded to ICD-10-AM Chapter 19 Injury, Poisoning and Consequences of External Cause S00-T98)
• Body region injured - head, thorax, shoulder, upper arm etc. Body region information is derived from the injury diagnosis variables.
• Nature of main injury - open wound, fracture, dislocation/sprain/strain etc. Nature of main injury is derived from the injury diagnosis variables.
• Comorbidities - co-occurrence of injury with other diseases and conditions that can happen by chance or because there is some association between them (for example, suicide and mental disorders, drowning or hot water scalds and epilepsy). Co-morbidities are derived from the diagnosis variables (Coded to ICD-10-AM Chapters 1-17).

Find out more about VAED.

Emergency Department (ED) presentations 

Source: Victorian Emergency Minimum Dataset (VEMD)

The Victorian Injury Surveillance System (VISS) began in the Royal Children's Hospital in 1989. It expanded to adult hospitals over time with a large boost in 1995 when the Department of Human Services absorbed the injury surveillance minimum dataset into the Victorian Emergency Minimum Dataset (VEMD) that collects demographic, administrative and clinical data from public hospitals. From January 2004, VEMD data are collected by all 38 Victorian public hospitals that provide a 24-hour ED service.

Emergency Department (ED) presentations for injury and poisoning are extracted from the VEMD by the Victorian Department of Health and supplied quarterly in unit record format to VISU (prior to 2004 VISU collected injury surveillance data directly from hospital EDs). Data are currently coded to the Victorian Emergency Minimum Dataset (VEMD) User Manual 16^th Edition, July 2011-12 published by the Department of Health.

The VEMD contains both cases that are treated and discharged from the ED within four hours from the time patient management commences (i.e. ‘non-admissions') and cases that are defined as ‘admissions' because they are treated for four hours or more in the ED or a short stay ward attached to the ED or depart from the ED to an inpatient bed or are transferred to another hospital campus. Admissions recorded on the VEMD are not usually included in injury surveillance reports if admissions are also being selected from the VAED because cases would then be over counted.    

When the data file is received by VISU, it is cleaned, checked and merged with the VISU-VEMD injury surveillance dataset. VISU is able to run data searches on any of the data items contained in the dataset to provide a customised report containing a set of tables and short interpretive summary.

VEMD data items 

Patient demographic and administrative items

• Age, sex, postcode and suburb of residence
• Country of birth, preferred language spoken at home
• Time and date of presentation to ED
• Departure status (patient destination on discharge from ED i.e. admitted to ward, died within ED, discharged home, discharged to residential care etc.)
• Referred to on departure (outpatients, local medical officer i.e. GP, home nursing service, scheduled review in ED etc.)

Injury surveillance items

• Human intent - unintentional, assault, self harm etc.
• Cause of injury - fall, poisoning etc.
• Place where injury occurred (location of injury) - home, road/street/highway etc.
• Activity when injured - sports, leisure, work etc.
• Nature of main injury - fracture, sprain/strain etc.
• Body region injured - head/face/neck, upper extremity, trunk etc.
• Description of injury event (case narrative) - short text description of what happened

Find out more about VEMD