Assessment of the potential for surveillance of alcohol-related casualties using National Hospital Discharge Survey data.

It is well known that alcohol abuse is significantly involved in the incidence of casualties (that is, accidents and injuries as they are defined for the purpose of coding diagnoses in the International Classification of Diseases). Thus, a study was conducted of the feasibility of using data from the National Hospital Discharge Survey (NHDS) for the surveillance of alcohol-related casualties. Trends were analyzed over 7 years (1979-85), and results were discussed from three aspects: number and rates for comorbidity of injuries and accidents with alcohol-related diagnoses, percent of alcohol involvement for injuries and accidents, and proportionate morbidity for alcohol-related and nonalcohol-related injuries and accidents. The incidence of comorbidity and percent of alcohol involvement were found to be relatively low for both accidents and injuries--underreporting being a likely cause. Comorbidity rates over the 7-year period showed no major trends in the rates for injuries that were associated with alcohol use, but the rates for accidents that were associated with alcohol use increased in all but one of the years. Proportionate morbidity as reflected in hospital discharge records with alcohol-related diagnoses showed only small differences by sex and age group (except the 14 to 25 years group) for either injuries or accidents. Only the 25- to 44-year-old group showed a time-trend increase, and that is only for the accident category. For these reasons, we have concluded that data from the NHDS are not currently adequate for use in the surveillance of alcohol-related injuries and accidents.