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2017 Annual Meeting

September 12–14, 2017

Aurora, Colorado

The links below contained detailed information for the upcoming 2017 Safe States Alliance Annual Meeting, taking place September 12-14, 2017 in Aurora, Colorado.

Please note:

Climbing the Data Steps: Death Certificates, Hospital Discharges, APCD

Thursday, September 14, 2017 at 9:45 AM–11:00 AM MDT
Conference Room 2
Learning Objectives

1. Understand and articulate the difference between incidence and prevalence.

2. Describe the different categories of information provided with the APCD.

3. Identify two uses of the APCD and two complexities associated with it's use.

Statement of Purpose

The incidence of traumatic brain injury (TBI) is readily described using hospital discharge data. It has been difficult, however, to describe the prevalence of TBI. It has also been difficult to describe, within public health surveillance, the services utilized by TBI survivors, the different sub-populations involved, and any existing disparities. The All Payer Claims Database (APCD), which includes ambulatory care data, is now available in 14 states. It can be used to describe persons with TBIs who are treated in non-hospital settings, which will allow improved estimates of the incidence and prevalence of TBI as well as describe services received by TBI survivors. This will better illustrate the true burden of TBI in the state.



Utilizing Minnesota’s APCD data, all ED-treated and hospitalized TBI cases from 2009 - 2013 were identified, along with follow-up visits, using TBI diagnosis codes indicative of current injury.

Follow-up visits for TBI survivors were identified, and then evaluated for frequency, purpose and services utilized.

Different sub-populations are described epidemiologically and differential utilization of services was explored.



The APCD data was found to be a very complex data set, and very challenging with which to work.

Concussions described by the APCD were found to be a notable subset of TBI, with age distributions different from hospitalized data but similar to ED-treated cases.

Using any-listed diagnosis of TBI found in the APCD is overly sensitive for use in estimating incidence and prevalence.

Conclusions & Significance to the Field

Identified services can be compared with the services offered through Resource Facilitation, a science-based and evidence-based strategy provided by the Minnesota Brain Injury Alliance.


While APCD data is difficult and time-consuming with which to work, because it potentially fills in data voids identified by CDC, exploration of this data should be continued.



Leslie Seymour, MD, MPH, Minnesota Department of Health

Dr. Leslie Seymour has been an epidemiologist with the Minnesota Department of Health (MDH) since 2007, working with the Injury and Violence Prevention Section. She currently works as the lead epidemiologist in the analyses, public health surveillance, and epidemiologic investigations of TBI/SCI and is the program coordinator for Minnesota’s Core State Violence and Injury Prevention Program (Core SVIPP).

Dr. Seymour received both her Doctor of Medicine and Master of Public Health degrees at the University of Minnesota.


Anna Gaichas, MS, Minnesota Department of Health
Mr Jon Roesler, MS, Minnesota Department of Health
Mr. Mark Kinde, MPH, Minnesota Department of Health

Primary Contact

Leslie Seymour, Minnesota Department of Health