Compensation Research Database (CRD) Alex Collie Chief Investigator Rasa Ruseckaite Acting Senior Research Fellow Khic-Houy Prang Research Assistant Maatje Sheepers Research Assistant Adrian Buzgau Senior Database Analyst CREPS Registry SIG meeting presentation 24 May 2013 Outline 1. What is the CRD? 2. How you can use the CRD? 3. CRD data linkage
What is CRD? The CRD and how it works Platform to support research involving people who have received injury compensation Two separate administrative databases WorkSafe Victoria Transport Accident Commission (TAC) Updates undertaken annually for each dataset. Physically located at Monash Clayton server farm in an SQL server with secure remote access by CRD project team
Information Privacy Both datasets have potentially re-identifiable data Researchers are not given access to any re-identifiable information The CRD maintains a key which allows data linkage projects but only with WorkSafe & TAC involvement Analysis variables Identifiers Analysis variables Linkage occurs with data custodians Linked to Victorian Trauma Registry and in the process with Medicare and Victorian Hospital episodes data WorkSafe Victoria dataset Services 80,690,241 records 11 variables 85 % of the Victorian workforce receive workers compensation from WorkSafe - must have 10+ days off work, or medical excess Medical Certificates 9,367,799 records 21 variables Claims 1,890,668 records 102 variables Payments 66,133,914 records 16 variables 1985 to 2012 All datasets linked by claim ID Hospital Admissions 549,043 records 11 variables Services, payments and certificates also linked by Provider ID
Description of Work Safe cohort Characteristic n % Mean Age (sd) 37.7 (12.9) Male Gender 654,537 66.1 Injury types Dislocation/ traumatic tendon injury 383,057 38.7 Wounds 240,649 24.3 Chronic musculoskeletal disorders 126,384 12.8 Fractures 61,618 6.1 Mental disorders 38,825 3.9 Occupation types Manufacturing 259,907 26.2 Wholesale trade/construction 153,567 15.5 Health care 115,475 11.7 Education and training 66,540 6.7 Mean days off work (sd) 85.1 (339) Median payment amount (IQR) $410 (0-3638) TAC dataset Includes all police-reported transport incidents in Victoria and drivers and occupants of Victorian registered vehicles involved in interstate collisions. Claims 501,152 records 45 variables Services / Payments 30,081,807 records 20 variables TAC claims from 1987 to 2012 Datasets linked by claim ID Services and payments include cost and dates of care, including GP consultations, psychology, physiotherapy, chiropractor utilisation, lost wages, vocational counselling, chemist and post acute support services.
Description of TAC cohort Characteristic n % Mean Age (sd) 36.0 (19.1) Male Gender 263,923 51.6 Injury types Contusion/abrasions 144,588 28.3 Whiplash 140,755 27.5 Fracture - limb 57,173 11.2 Fracture - other 29,960 5.9 Sprains/strains 22,769 4.5 Mild Acquired Brain Injury 20,830 4.1 Median number of accidents (range) 1 (1-11) Hospital admission 314,387 61.4 Median no fault amount paid $943.40 (121.50-4129.85) How CRD can be used?
Other projects undertaken to date Patterns of post-injury health service utilisation (TAC) Predictors of excessive health service utilisation (WorkSafe) Recurrent work injury and disease (WorkSafe) Patterns of medical certification behaviour amongst GPs (WorkSafe) Measures of work disability / return to work (WorkSafe & TAC) The impact of ageing on return to work (WorkSafe) Predictors of common law claims (TAC) The incidence and impact of occupational dermatitis (WorkSafe) The incidence of work injury and disease during hot weather (WorkSafe) The impact of ageing on workplace injury and workers compensation schemes (WorkSafe) Effects of claim factors on health service utilisation (TAC)
Accessing the CRD Researcher Complete data request form on the ISCRR website http://www.iscrr.com.au/research/research-programs/compensation-research-database.aspx CRD Project team Receive data request De-identify requested data Create data tables Chief Investigator & Steering Committee Prioritise data requests Review and approve individual data requests Researcher Receive and analyse data CRD data linkages
Strengths and Limitation of the CRD Includes information on non-acute care received Lacks clinical detail Contains longitudinal information on care for injury Coders are not clinically trained Cost-effective data source on a large number of people Errors in clinical detail identified in the past Data on RTW outcomes Not designed for research questions Cost of care is relatively accurate Variability in the quality of different data elements Why to do linkages? Data linkage is defined as the bringing together from two or more different sources data that relate to the same individual, family, place or event. (Last, 2001) As the CRD is an administrative data source which lacks detailed clinical information, data linkage with clinical registries is a high priority to enhance the existing data.
VOTOR/VSTORM linkage Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) and Victorian State Trauma Registry (VSTORM) linkage with the TAC data Aim: to investigate interactions between clinical and medical factors and individual and system level factor Findings from the project will inform the policy and practice of the TAC and thus have the potential to substantially impact the health of those injured at work or in transport accidents DHS linkage Linkage with the Victorian Admitted Episodes Dataset (VAED) and the Victorian Emergency Minimum Dataset (VEMD). VAED and VEMD hold state-wide hospital and emergency department episodes data and are maintained by the DHS. Primary Aim: to examine hospital utilisation patterns of WSV claimants to determine whether previous healthcare utilisation and existing comorbidity impacts the injury recovery process. Secondary Aim: to determine whether hospital and emergency department utilisation patterns differ for people with compensated injuries and those without compensation.
MEDICARE linkage CRD data linkage with Medicare Benefits Scheme (MBS) and Pharmaceutical Benefits Scheme (PBS). Project involves following a cohort of Victorians with work related injuries through the compensation scheme, to stable recovery. Aim: to provide unique insight into the impact of pre-existing health conditions and a range of other system-level & individual-level characteristics on injury outcomes. This study is designed to generate knowledge of factors that predict outcomes and identify high-risk groups, as well as knowledge of system-level, modifiable risk factors that that can inform disability prevention strategies.