511 Enhancing road traffic injury surveillance in Bandung, Indonesia through linkage of hospital and police data

<h3></h3> Road traffic injuries (RTI) are underreported in many countries. In Indonesia, the national road crash data system (the Integrated Road Safety Management System, IRSMS) of the Indonesian Traffic Police reported a fatality rate of 8.8 per 100,000 in 2020, compared to the WHO estimate of 12.2 per 100,000. Accurate estimates of burden are needed to prioritize road safety interventions. As one element of the Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS) program, it aims to implement more complete surveillance of RTI serious injuries and deaths in Bandung, Indonesia in order to inform intervention decisions. The city health department obtained data from police crash reports and convened representatives from all secondary and tertiary care hospitals in the city, inviting them to participate in monthly reporting of RTI admissions and deaths. A simple 10-variable format was set up to extract from existing hospital management information systems. A surveillance coordinator collected these reports, linked fatal cases to police crash fatality reports and victims’ insurance records, and analyzed the data. At semi-annual feedback meetings, reporting challenges and findings were shared with hospital staff. Linked data was included in annual city road safety reports to inform road safety intervention decisions. A total of 21 hospitals participated in the new RTI reporting system. During 2017–2018, these hospitals reported 258 RTI deaths, of which 179 were from crashes inside the city. Police and insurance reported 300 deaths in the same period, and 108 cases could be matched. Applying a capture-recapture estimation formula, we estimate there were 496 deaths in the 2-year period, suggesting police sources only captured 60% of deaths, indicating a significant level of underreporting. With monitoring support, hospitals continued to report routinely. Analyses and reports were widely disseminated among government officials and media. Linkage of police, insurance, and hospital RTI data on a routine basis was feasible and possible to be adapted in different cities in Indonesia to assess the extent of underreporting data. The data linkage resulted in improved mortality estimates and was useful in defining appropriate interventions to reduce RTI and deaths.