DOCSLIB.ORG

Ehid) Project Number: 2003129

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Ehid) Project Number: 2003129 Project title: Electronic Health Indicator Data (eHID) Project number: 2003129 Contract number: 2003129 Programme: Public Health and Risk Assessment, Health and Consumer Protection. Strand I: Health Information Priority 2.2.5: eHealth Directorate General SANCO European Commission LEAD AUTHORS: Douglas M Fleming, project leader1 Catherine Elliott, project facilitator2 Michael Pringle, scientific officer2 1Royal College of General Practitioners, Birmingham 2Division of Primary Care, University of Nottingham On behalf of the Project Group: John Sahl Andersen, University of Copenhagen Isabel Falcao, Public Health Institute, Portugal Gilles Hebbrecht, French Society of General Practice (SFMG) Roberto Nardi, European School of General Practice, Italy (SIMG) Valeria Pacheco, XIIAP Jordi Gol Institute, Spain Viviane Van Casteren, Scientific Institute of Public Health, Belgium Robert Verheij, The Netherlands Institute for Health Services Research (NIVEL) and Jean K Soler, Transhis Network, Malta Stefaan Bartholomeeusen, Catholic University of Leuven and Intego Network, Flanders Helen Boardman2, project facilitator Feb 2005-Oct 2005 Didier Duhot, French Society of General Practice (SFMG) Henrik Schroll, DAK-E Network, University of Southern Denmark Jouke van der Zee, The Netherlands Institute for Health Services Research (NIVEL) Project Monitor: Jose Marinho Falcao, Public Health Institute, Portugal Date: 9th April 2008 TABLE OF CONTENTS EXECUTIVE SUMMARY............................................................................... 4 Chapter 1: INTRODUCTION ...................................................................... 10 Background ......................................................................................................... 10 Computer use in primary care.......................................................................... 12 Project Aims ........................................................................................................ 15 Choice of Indicator diseases ............................................................................ 16 Chapter 2: PARTNERS, MATERIAL, METHODS AND WORK PLAN ....... 18 Project Partners.................................................................................................. 18 Material ................................................................................................................ 19 Site visits.......................................................................................................... 19 Statistical data from the networks................................................................ 20 Chapter 3: SITE VISITS ............................................................................. 22 Introduction.......................................................................................................... 22 Method ................................................................................................................. 22 Commentary on visits to network leaders ...................................................... 22 Brief description of networks ........................................................................ 23 Network Structures......................................................................................... 24 Ethical considerations.................................................................................... 24 Recruitment of GPs to the networks ........................................................... 25 Data recording and collection....................................................................... 26 Data Entry: menu driven software.............................................................. 27 Prevalence, incidence and episode typing................................................. 27 Data quality measures................................................................................... 29 Training, feedback and input of GPs........................................................... 31 Network organisation opinions of strengths and weaknesses in the systems............................................................................................................ 31 Findings from visits to participating GPs ........................................................ 32 Recording in GP computer systems............................................................ 32 Recording for eHID indicator conditions..................................................... 35 GPs opinions of strengths and weaknesses in the systems ................... 35 The growth of practice information networks................................................. 36 Chapter 4: ANALYSIS OF HEALTH INDICATOR DISEASES ................... 38 Introduction.......................................................................................................... 38 Prevalence of diabetes...................................................................................... 42 Comments on results for diabetes................................................................... 44 Incidence of Ischaemic Heart Disease ........................................................... 45 Prevalence of Ischaemic Heart Disease ........................................................ 47 Comments on results for ischaemic heart disease....................................... 48 2 Prevalence of doctor assessed mental illness .............................................. 49 Prevalence of dementia .................................................................................... 50 Prevalence of schizophrenia ............................................................................ 52 Prevalence of affective psychoses.................................................................. 53 Comments on results for mental illnesses ..................................................... 54 Perception of mental illness.......................................................................... 54 The recording process................................................................................... 55 Source of care................................................................................................. 55 Concern about the record content............................................................... 55 Gender differences ............................................................................................ 56 Overall discussion of the results...................................................................... 57 Chapter 5: CRITICAL ISSUES FOR EPIDEMIOLOGICAL INVESTIGATION .................................................................................................................... 58 Denominator issues ........................................................................................... 58 Diagnostic definition........................................................................................... 64 Disease Classification ....................................................................................... 67 The Dictionary of Consultation Results (DCR ........................................... 67 The International Classification of Disease................................................ 68 International Classification of Primary Care (ICPC) ................................. 69 The Primary-Secondary care interface........................................................... 70 Chapter 6: PRACTICE BASED NETWORKS............................................. 71 The role of sentinel practice networks ............................................................ 71 Network aims ...................................................................................................... 73 Representativeness of networks...................................................................... 74 Network organisation......................................................................................... 75 Network Recruitment Criteria ....................................................................... 76 Chapter 7: RECOMMENDATIONS .......................................................... 77 Computer software............................................................................................. 77 Recorder tasks.................................................................................................... 78 Confidentiality and Data Transfer Procedures .............................................. 79 Classification and Diagnosis Definition........................................................... 80 Denominator definition ...................................................................................... 81 Further developments........................................................................................ 82 REFERENCES............................................................................................ 83 Appendix 1: AGENDA POINTS AT eHID MEETINGS................................. 87 Appendix 2: REPORTS FROM THE eHID PROJECT MONITOR: José Marinho Falcão............................................................................................ 88 Appendix 3: PORTUGAL REPORT........................................................... 102 Appendix 4: DATA RETURNS FROM THE PARTICIPANT NETWORKS FOR 2004 AND 2005 ................................................................................ 104 ACKNOWLEDGEMENTS ......................................................................... 113 LIST OF ABBREVIATIONS....................................................................... 114 3 EXECUTIVE SUMMARY
Load more

Recommended publications
  • Iraq Health Information System Review and Assessment July, 2011
    Iraq Health Information System Review and Assessment July, 2011 By: Ministry of Health, MOHE, MOP/CSO, MOD, WHO Coordinated by: Ministry of Health, Babb AL‐Moadham, Baghdad, Iraq Contact Authors: 1. Dr. Ahlam aziz Ali, Director of Donor Affaire Section, Senior Deputy Minister’s Office, MOH E‐ mail: [email protected] Mobile No.: +964 7901940669 2. Dr. Imad Abdulsalam, Director of Health & Vital Statistic Department, Planning Directorate, MOH. E‐ mail: [email protected] Mobile No.: +964 7901925619 3. Dr. Ali Mahmood Hasan, Director of Health Statistic Section, Directorate of Planning, MOH. E‐ mail: [email protected] Mobile No.: +964 7902649103 This report describes the current status of the National Health Information System (NHIS) in Iraq. The assessment of the NHIS was carried out by the HIS Stakeholders Working Group in Baghdad, Iraq from 8‐10 March 2011 Table of contents List of Acronyms .................................................................................................................................................. 3 Foreword ............................................................................................................................................................ 5 Acknowledgement .............................................................................................................................................. 6 Executive summary ............................................................................................................................................. 7 I. Background
    [Show full text]
  • Health Indicator Frameworks
    PRAIRIE WOMEN’S HEALTH CENTRE OF EXCELLENCE RESEARCH POLICY COMMUNITY Be er Evidence to Improve Women’s Health with Gender and Health Sta s cs: Health Indicator Frameworks M. Haworth-Brockman H. Isfeld Prairie Women’s Health Centre of Excellence (PWHCE) is one of the Centres of Excellence for Women’s Health, funded by the Women’s Health Contribution Program of Health Canada. PWHCE supports new knowledge and research on women’s health issues; and provides policy advice, analysis and information to governments, health organizations and non-governmental organizations. Production of this document has been made possible through a financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of PWHCE or Health Canada. This paper was an invited concept paper, developed in preparation for a World Health Organization meeting, A Policy Dialogue for Better Evidence to Improve Women’s Health through Gender and Health Statistics, held October 25-27, 2010 in Washington DC. The Prairie Women’s Health Centre of Excellence 56 The Promenade Winnipeg, Manitoba R3B 3H9 Telephone: (204) 982-6630 Fax: (204) 982-6637 Email: [email protected] This report is also available on our website: www.pwhce.ca This is project #253 of Prairie Women’s Health Centre of Excellence ISBN # 978-1-897250-37-2 Better Evidence to Improve Women’s Health with Gender and Health Statistics: Health Indicator Frameworks M. Haworth‐Brockman H. Isfeld Acknowledgements This paper was an invited concept paper, developed in preparation for a World Health Organization meeting, A Policy Dialogue for Better Evidence to Improve Women’s Health through Gender and Health Statistics, held October 25-27, 2010 in Washington DC.
    [Show full text]
  • Expert Voices for Change Bridging the Silos—Towards Healthy and Sustainable Settings for the 21St Century
    Article Expert voices for change: Bridging the silos—towards healthy and sustainable settings for the 21st century Dooris, Mark T Available at http://clok.uclan.ac.uk/6890/ Dooris, Mark T ORCID: 0000-0002-5986-1660 (2013) Expert voices for change: Bridging the silos—towards healthy and sustainable settings for the 21st century. Health & Place, 20 (-). pp. 39-50. ISSN 13538292 It is advisable to refer to the publisher’s version if you intend to cite from the work. http://dx.doi.org/10.1016/j.healthplace.2012.11.009 For more information about UCLan’s research in this area go to http://www.uclan.ac.uk/researchgroups/ and search for <name of research Group>. For information about Research generally at UCLan please go to http://www.uclan.ac.uk/research/ All outputs in CLoK are protected by Intellectual Property Rights law, including Copyright law. Copyright, IPR and Moral Rights for the works on this site are retained by the individual authors and/or other copyright owners. Terms and conditions for use of this material are defined in the policies page. CLoK Central Lancashire online Knowledge www.clok.uclan.ac.uk Health & Place 20 (2013) 39–50 Contents lists available at SciVerse ScienceDirect Health & Place journal homepage: www.elsevier.com/locate/healthplace Expert voices for change: Bridging the silos—towards healthy and sustainable settings for the 21st century Mark Dooris n Healthy Settings Unit, School of Health, University of Central Lancashire, UK article info abstract Article history: The settings approach to health promotion, first advocated in the 1986 Ottawa Charter for Health Received 17 May 2012 Promotion, was introduced as an expression of the ‘new public health’, generating both acclaim and Received in revised form critical discourse.
    [Show full text]
  • Framework and Standards for Country Health Information Systems Second Edition Health Metrics Network
    HealtH metrics network Framework and Standards for Country Health Information Systems SeCond edItIon Health metrics netwORk Framework and Standards for Country Health Information Systems SecoND editioN WHO library Cataloguing-in-Publication Data : Framework and standards for country health information systems / Health Metrics Network, World Health Organization. – 2nd ed. 1.Information systems - organization and administration. 2.Information systems - standards. 3.Data collection - methods. 4.Data collection - standards. 5.Public health informatics - methods. 6.Health planning. I.Health Metrics Network. II.World Health Organization. ISBN 978 92 4 159594 0 (NlM classification: W 26.5) © World Health Organization 2008. Reprinted 2012. All rights reserved. Publications of the World Health Organization are available on the WHO web site ( www.who.int ) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncom- mercial distribution – should be addressed to WHO Press through the WHO web site (http://www.who.int/ about/licensing/copyright_form/en/index.html). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned.
    [Show full text]
  • Improving Healthcare Quality in Europe
    Cover_WHO_nr52.qxp_Mise en page 1 20/08/2019 16:31 Page 1 51 THE ROLE OF PUBLIC HEALTH ORGANIZATIONS IN ADDRESSING PUBLIC HEALTH PROBLEMS IN EUROPE PUBLIC HEALTH IN ADDRESSING ORGANIZATIONS PUBLIC HEALTH THE ROLE OF Quality improvement initiatives take many forms, from the creation of standards for health Improving healthcare 53 professionals, health technologies and health facilities, to audit and feedback, and from fostering a patient safety culture to public reporting and paying for quality. For policy- makers who struggle to decide which initiatives to prioritise for investment, understanding quality in Europe Series the potential of different quality strategies in their unique settings is key. This volume, developed by the Observatory together with OECD, provides an overall conceptual Health Policy Health Policy framework for understanding and applying strategies aimed at improving quality of care. Characteristics, effectiveness and Crucially, it summarizes available evidence on different quality strategies and provides implementation of different strategies recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies. Edited by Quality of care is a political priority and an important contributor to population health. This Reinhard Busse book acknowledges that "quality of care" is a broadly defined concept, and that it is often Niek Klazinga unclear how quality improvement strategies fit within a health system, and what their particular contribution can be. This volume elucidates the concepts behind multiple elements Dimitra Panteli of quality in healthcare policy (including definitions of quality, its dimensions, related activities, Wilm Quentin and targets), quality measurement and governance and situates it all in the wider context of health systems research.
    [Show full text]
  • Rethinking European Union Foreign Policy Prelims 7/6/04 9:46 Am Page Ii
    prelims 7/6/04 9:46 am Page i rethinking european union foreign policy prelims 7/6/04 9:46 am Page ii EUROPE IN CHANGE T C and E K already published The formation of Croatian national identity A centuries old dream . Committee governance in the European Union ₍₎ Theory and reform in the European Union, 2nd edition . , . , German policy-making and eastern enlargement of the EU during the Kohl era Managing the agenda . The European Union and the Cyprus conflict Modern conflict, postmodern union The time of European governance An introduction to post-Communist Bulgaria Political, economic and social transformation The new Germany and migration in Europe Turkey: facing a new millennium Coping with intertwined conflicts The road to the European Union, volume 2 Estonia, Latvia and Lithuania () The road to the European Union, volume 1 The Czech and Slovak Republics () Europe and civil society Movement coalitions and European governance Two tiers or two speeds? The European security order and the enlargement of the European Union and NATO () Recasting the European order Security architectures and economic cooperation The emerging Euro-Mediterranean system . . prelims 7/6/04 9:46 am Page iii Ben Tonra and Thomas Christiansen editors rethinking european union foreign policy Modern conflict, postmodern union Security architectures and economic cooperation MANCHESTER UNIVERSITY PRESS Manchester and New York distributed exclusively in the USA by Palgrave prelims 7/6/04 9:46 am Page iv Copyright © Manchester University Press 2004 While copyright in the volume as a whole is vested in Manchester University Press, copyright in individual chapters belongs to their respective authors.
    [Show full text]
  • A Step-By-Step Guide to Promoting Health on The
    The Florida Wellness A step-by-step guide to promoting Way health on the job UF/IFAS Extension Family Nutrition Program (FNP) SNAP-Education in Florida CONTACT FNP Visit us online and find a local contact at: 1408 Sabal Palm Dr., 2nd Floor, familynutritionprogram.org PO Box 110320 Gainesville, FL 32611-0320 An Equal Opportunity Institution TABLE OF CONTENTS The Guide .......................................................................................................................... i About FNP ......................................................................................................................... i Acknowledgments .......................................................................................................... ii The Florida Wellness Way ............................................................................................. iii Why This Way? ............................................................................................................... iv ASSESS YOUR WORKPLACE .......................................................................... 1-2 FORM A WELLNESS COMMITTEE ............................................................... 3-6 CREATE A SUPPORTIVE WORKPLACE CULTURE .............................. 7-26 Partner to Provide Health Education ................................................. 9-10 Host a Health Fair ................................................................................. 11-13 Host Healthy Meetings ......................................................................
    [Show full text]
  • Peoria County Community Health Indicator Report Provides Health Status Information on Various Population Health Indicators Within the County
    Peoria County Community Health Indicator 2015 Report Providing and highlighting Peoria County's progress on various health benchmarks including causes of death, risk and protective factors, and socioeconomic indicators. 2116 N. Sheridan Rd ● Peoria, Illinois 61604 ● 309.679.6000 Table of Contents Community Demographics 1 Population, Gender, Age, Race, Ethnicity Health Outcomes 2-6 Leading Causes of Death (mortality) 2 Disease (morbidity) Cardiovascular Disease, Cholesterol, & Hypertension 3 Cancer 4 Diabetes 5 Respiratory Disease, COPD, & Asthma 6 Health Behavior 7-10 Tobacco Use & Exposure 7 Healthy Weight: Obesity & Physical Activity 8 Maternal & Child Health 9 Sexually Transmitted Infections 10 Social & Economic Factors 11 Employment, Income, Education, Family & Social Support, Community Safety Data Sources 12 Introduction The Peoria County Community Health Indicator Report provides health status information on various population health indicators within the county. The Report examines the leading causes of death, morbidity, health risk and protective factors, maternal and child health, and both general and socioeconomic demographics. It seeks to compare the status of Peoria County's population health with that of Illinois and the United States. The measures within the Report are meant to demonstrate how health is multidimensional and related not only to disease, but behavior and economic factors within a community. Community Demographics: Peoria County Peoria County is located in central Illinois, along the Illinois River. While much of the County is rural, the majority of the population resides within 50 square miles of the City of Peoria -- the county seat and seventh most populous city in the state. While White and African Americans make up the majority of the population, between the 2000 and 2010 Census, the percentage of both Asian and Hispanics doubled.
    [Show full text]
  • National Prevention Strategy AMERICA’S PLAN for BETTER HEALTH and WELLNESS
    National Prevention Strategy AMERICA’S PLAN FOR BETTER HEALTH AND WELLNESS June 2011 National Prevention, Health Promotion and Public Health Council For more information about the National Prevention Strategy, go to: http://www.healthcare.gov/center/councils/nphpphc. OFFICE of the SURGEON GENERAL 5600 Fishers Lane Room 18-66 Rockville, MD 20857 email: [email protected] Suggested citation: National Prevention Council, National Prevention Strategy, Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General, 2011. National Prevention Strategy America’s Plan for Better Health and Wellness June 16, 2011 2 National Prevention Message from the Chair of the National Prevention,Strategy Health Promotion, and Public Health Council As U.S. Surgeon General and Chair of the National Prevention, Health Promotion, and Public Health Council (National Prevention Council), I am honored to present the nation’s first ever National Prevention and Health Promotion Strategy (National Prevention Strategy). This strategy is a critical component of the Affordable Care Act, and it provides an opportunity for us to become a more healthy and fit nation. The National Prevention Council comprises 17 heads of departments, agencies, and offices across the Federal government who are committed to promoting prevention and wellness. The Council provides the leadership necessary to engage not only the federal government but a diverse array of stakeholders, from state and local policy makers, to business leaders, to individuals, their families and communities, to champion the policies and programs needed to ensure the health of Americans prospers. With guidance from the public and the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health, the National Prevention Council developed this Strategy.
    [Show full text]
  • Global Health Indicators: an Overview
    Commentary Commentaire Global health indicators: an overview Charles Larson, Alec Mercer ß See related article page 1203 he health of people living in developing countries precursors of both. In contrast, in developed countries a around the world has improved considerably over the large proportion of the key health indicators reflect lifestyles T past 2 decades. For example, the total number of and individual behaviour, such as physical exercise, smoking, deaths annually among children less than 5 years of age has diet, or substance and alcohol abuse. been halved over the past 40 years.1 Unfortunately, in most of Because of cost constraints and limited logistic capacity, sub-Saharan Africa and some parts of South Asia, these reduc- few developing countries are able to maintain death, birth or tions in mortality have stagnated or even reversed over the disease registries. Data generated by health care institutions past decade.2 At the same time, disease patterns and causes of are more readily available and more frequently used, but must death in less developed countries have changed markedly. The be viewed with caution because they are not representative of most obvious example of such change relates to HIV/AIDS, the general population. In developing countries, a biased mi- but others include the re-emergence of tuberculosis as a global nority of the population (typically urban, wealthy and better health problem, the emergence of new infectious diseases, the educated) use modern medical services. Furthermore, for sev- increase in violence and the occurrence of chronic diseases eral presenting health problems, only patients exhibiting the formerly thought to be of concern only in developed coun- most severe end of the spectrum ever reach a health care fa- tries, such as coronary artery disease and cerebrovascular acci- cility.
    [Show full text]
  • Pdf Montgomery County Health Indicator Fast Facts
    Montgomery County Health Indicator Fast Facts Poverty by Race/Ethnicity Percent Poverty Source: Montgomery County Poverty 17.9 Black or African American 32.8 White 13.3 U.S. Census Bureau, 2013-2017 American Community Survey 5-Year American Indian/Alaska Native 36.0 Estimates Asian/Pacific Islander 11.9 Hispanic/Latino 32.6 Child Poverty 27.6 U.S. Census Bureau, 2013-2017 Black or African American 50.3 American Community Survey 5-Year Estimates White 19.2 Adult Poverty 15.0 U.S. Census Bureau, 2013-2017 Black or African American 26.7 American Community Survey 5-Year Estimates White 11.7 Uninsured by Race/Ethnicity Percent Uninsured Source: Montgomery County Uninsured 8.0 Black or African American 10.1 White 7.1 U.S. Census Bureau, 2013-2017 American Community Survey 5-Year American Indian/Alaska Native 10.3 Estimates Asian/Pacific Islander 4.3 Hispanic/Latino 22.1 Children Uninsured 4.1 U.S. Census Bureau, 2013-2017 Black or African American 4.0 American Community Survey 5-Year Estimates White 3.6 Adults Uninsured 9.2 U.S. Census Bureau, 2013-2017 Black or African American 12.4 American Community Survey 5-Year Estimates White 8.1 Unemployment Percent Unemployed Source: U.S. Census Bureau, 2013-2017 Unemployed Population 16+ years 8.0 American Community Survey 5-Year Estimates Age-adjusted Rate Causes of Death by Race/Ethnicity Source: (per 100,000) Montgomery County Heart Disease 176.8 Black or African American 233.3 White 165.3 Ohio Department of Health Data American Indian/Alaska Native * Warehouse, Mortality Files, 2016-2017 Asian/Pacific
    [Show full text]
  • Research Report: Selected Case-Law of the European Court of Human Rights on Young People
    RESEARCH REPORT _______________________ Selected case-law of the European Court of Human Rights on young people Publishers or organisations wishing to reproduce this report (or a translation thereof) in print or online are asked to contact [email protected] for further instructions. © Council of Europe/European Court of Human Rights, 2012 The document is available for downloading at www.echr.coe.int (Case-law – Case-Law Analysis – Research Reports). This document has been prepared by the Research Division and does not bind the Court. The text was finalised in November 2012, and may be subject to editorial revision. 2 COMPILATION OF RELEVANT CASE-LAW OF THE EUROPEAN COURT OF HUMAN RIGHTS ON YOUNG PEOPLE Compilation of Relevant Case-law of the European Court of Human Rights on Young People between 18 and 35 Years This compilation summarises the relevant case-law of the European Court of Human Rights on specific areas of importance for young people between 18 and 35 years: - Access to a professional career (under A.) ………………………………………….. 4 Bigaeva v. Greece, no. 26713/05, 28 May 2009 - Conscientious objection (under B.) …………………………………………………. 5 Savda v. Turkey, no. 42730/05, 12 June 2012 Bayatyan v. Armenia [GC], no. 23459/03, ECHR 2011 Thlimmenos v. Greece [GC], no. 34369/97, ECHR 2000-IV Koppi v. Austria, no. 33001/03, 10 December 2009 Gütl v. Austria, no. 49686/99, 12 March 2009 Löffelmann v. Austria, no. 42967/98, 12 March 2009 Ülke v. Turkey, no. 39437/98, 24 January 2006 Autio v. Finland, no. 17086/90, Commission decision of 6.12.1991 Johansen v.
    [Show full text]