Application of a public health framework to examine the characteristics of coroners%26apos; recommendations for injury prevention

作者：Bugeja Lyndal^*; Ibrahim Joseph Elias; Ozanne Smith Joan; Brodie Lisa Ruth; McClure Roderick J

来源：Injury Prevention, 2012, 18(5): 326-333.

DOI：10.1136/injuryprev-2011-040146

Objectives Exploring the characteristics of recommendations generated from medicolegal death investigations is an important step towards improving their contribution to injury prevention. This study aimed to: (1) quantify coroners%26apos; recommendations; and (2) examine the nature of these recommendations according to public health principles of injury causation and prevention. %26lt;br%26gt;Methods Deaths where coroners%26apos; recommendations were and were not made in the State of Victoria, Australia during the period 1 July 2000 to 30 June 2005 were compared by sex, age group and underlying cause of death. The nature of recommendations made was examined retrospectively using a derived model based on principles of injury causation and prevention, comprising seven elements: (1) priority population; (2) risk/contributing factors; (3) countermeasure; (4) level of intervention; (5) strategy for implementation; (6) organisation; (7) time frame for implementation. %26lt;br%26gt;Results Coroners%26apos; recommendations were relatively rare, made in only similar to 6% of external-cause deaths. When coroners did make recommendations, they were statistically significantly more likely for persons aged 0-14 years and deaths resulting from transport crashes, complications of medical and surgical care, drowning and inanimate mechanical forces. Of the coroners%26apos; recommendations, similar to 70% included at least four of the model%26apos;s seven elements. The elements %26apos;countermeasure%26apos; and %26apos;level of intervention%26apos; were most commonly specified by coroners (similar to 95%) in their recommendations. %26lt;br%26gt;Conclusions This study shows that highly evolved medicolegal death investigation systems may not draw systematically from the scientific research evidence base to inform the formulation of coroners%26apos; public health and safety recommendations. To maximise its contribution to fatal injury prevention, the medicolegal death investigation may benefit from incorporation of a public health perspective.

• 出版日期2012-10