[Current information of the Ministry (of Health) on health indicators].
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France↗
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Results for “Health Status Indicators”
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Comments on health indicators: methodological perspectives.
This paper discusses several basic conceptual and methodological problems in the development and use of health indicators. We observe that two tendencies of the health indicators movement may deter progress toward producing informations of health status indexes and the tendency to conceptualize "health" in terms of expansive definitions should measure variables specified by a social system model and should be scaled according to units that are relevant to decision-making criteria.
Decision Making↗
The black cloud over the Sunshine State: health disparities in south Florida.
Florida, the "Sunshine State", is paradise for international tourists and has been adopted as seasonal or permanent home by many wealthy individuals and celebrities. However, Florida is not paradise for the growing number of residents who suffer from poverty, health problems, and a lack of access to health care and social services. The purpose of this paper is to present data on health care problems and disparities throughout the state of Florida and in select south Florida counties. Flaskerud and Winslow (1998) have provided a framework which can be used to analyze disparities in resource availability, relative risk, and health status indicators and suggests areas in which nursing and other health professionals can ethically intervene through research, practice, and political action.
Adolescent↗
Using structured text and templates to capture health status outcomes in the electronic health record.
BACKGROUND: Because of the difficulty of implementing clinical outcomes-focused quality improvement (QI) projects, most organizations' efforts and comparative quality report cards have centered on structure and process indicators or on outcomes captured in administrative data systems. Ultimately, however, health care is intended to improve health. Health status is now frequently included in the set of quality of care information requested by purchasers of health care, accrediting and governmental agencies, and consumer groups. Subsequently, users of electronic health record (EHR) systems are demanding that the EHR support the collection and comparative analysis of health status information over time and by clinical population and provider. APPROACH: As opposed to the current practice in most organizations of collecting health status data via an annual mail survey, the approach discussed in this article utilizes standardized coding and classification (SCC) systems and standardized surveys to capture health status information in the EHR during the routine course of care delivery through the use of templates built on structured text. This method is illustrated with examples from the WAVE EHR. The EHR-based structured text and template approach facilitates the incorporation of health status measurement into the documentation of the patient-provider encounter, builds on recognized SCC systems and standardized surveys, and enables information retrieval for a variety of analyses, including those focused on QI. CONCLUSIONS: Health status outcomes are an essential component of an information set focused on health care quality. To routinely capture and analyze health status variables, SCC systems and standardized health status surveys are necessary.
Forms and Records Control↗
[Health survey in the elderly using home interviews: study of various indicators].
Questions asked on the occasion of health survey at home usually refer to frequency of medical consultations and prescribed drugs, but often also to reported somatic symptoms and self-evaluated general health status. Interview data collected in a population of aged widows and widowers revealed a high degree of concordance between these various health indicators, justifying in particular the value assigned to the subjective appreciation of the level of general health.
Aged↗
Economic transition and health transition: comparing China and Russia.
Drawing on experiences from China and Russia (the world's two largest transitional economies), this paper empirically examines the impact of economic reforms on health status. While China's overall health status continued to improve after the economic reform, Russia experienced a serious deterioration in its population health. The observed differences in health performance between China and Russia can be explained by the different impacts of economic reforms on three major socioeconomic determinants of health. Depending on whether or not the reform improves physical environment (as reflected in income level and nutritional status), social environment (including social stability and security system), and health care, we would observe either a positive or a negative net effect on health. Despite remarkable differences in overall health development, China and Russia share some common problems. Mental and social health problems such as suicides and alcohol poisoning have been on the rise in both countries. These problems were much more serious in Russia, where political and social instability was more pronounced, associated with Russia's relatively radical reform process. With their economies moving toward a free market system, health sectors in China and Russia are undergoing marketization, which has had serious detrimental effect on the public health services.
China↗
Excess mortality among urban residents: how much, for whom, and why?
OBJECTIVES: The goals of this study were to estimate prospective mortality risks of city residence, specify how these risks vary by population subgroup, and explore possible explanations. METHODS: Data were derived from a probability sample of 3617 adults in the coterminous United States and analyzed via cross-tabular and Cox proportional hazards methods. RESULTS: After adjustment for baseline sociodemographic and health variables, city residents had a mortality hazard rate ratio of 1.62 (95% confidence interval [CI] = 1.21, 2.18) relative to rural/small-town residents; suburbanites had an intermediate but not significantly elevated hazard rate ratio. This urban mortality risk was significant among men (hazard rate ratio: 2.25), especially non-Black men, but not among women. Among Black men, and to some degree Black women, suburban residence carried the greatest risk. All risks were most evident for those younger than 65 years. CONCLUSIONS: The mortality risk of city residence, at least among men, rivals that of major psychosocial risk factors such as race, low income, smoking, and social isolation and merits comparable attention in research and policy.
Activities of Daily Living↗
[Conceptualization and operationalization of social inequality in The Child and Adolescent Health Survey].
Poverty and social disadvantages are often accompanied by long-lasting social and psychosocial strain on the well-being and health of children and adolescents. From a health policy point of view the rising poverty quotas among young people indicate a high need for action. The status of empirical research is insufficient, so that it is difficult to plan and undertake political measures. The National Health Survey for Children and Adolescents will provide data permitting differentiated analysis of relations between poverty, social inequality and health in the adolescent generation. To get a first impression of possible analyses, the present article demonstrates which information on the living situation will be ascertained in the National Health Survey for Children and Adolescents, and which theoretical and methodological considerations have been playing a role.
Adolescent↗
Health indicators.
This paper examines the more general background to health indicators. It deals with the relation between health and social indicators, before examining the health concept. It discusses possible purposes for which health indicators should be developed, and gives some of the important data sources for this exercise. The paper contains some less traditional examples of health indicators as mainly applied in The Netherlands. Finally, it draws conclusions on the possibilities of developing health indicators.
Attitude to Health↗
Trends in oral health in the aging population.
Increased survival of the natural dentition, persistence of periodontal disease, deterioration of prior dental restorations, root surface caries, and continued incidence of oral cancer represent a complex of emerging oral health problems of the aged in the United States. Additional data on the epidemiology of oral mucous membrane syndromes will help to characterize the prevalence of these diseases in the aging population as well. Improvement in the utilization and accessibility of dental services by the aging cohorts will contribute to the prevention of oral disease in the future. Combined with the substantial growth in the size of this cohort of the population and alterations in the prevalence of these oral health status indicators, changes in the need for and projected utilization of professional oral health services can continue to be anticipated. Clinical research directed toward assessment of efficacy of treatment modalities for prevention of dental disease and maintenance of dental health are essential for the projection of dental health manpower needs for the future. This should also lead to the development of appropriate academic and training programs to meet the changing needs of the elderly.
Aged↗
A quantitative approach to perceived health status: a validation study.
The current recognition of the importance of perceived health status as a predictor of need for, and utilisation of, health services has led to attempts to produce indicators which assess subjective rather than objective health problems. The development of the Nottingham Health Profile is described, together with a study which tested the validity of the instrument on four groups of elderly people differing in health status. The results showed that the profile was capable of discriminating between groups differing in terms of diagnosed chronic illness, number of consultations at primary care level, and physiological fitness. Age, sex, and marital status were not significant overall in affecting scores. In these elderly subjects, perceived health status accorded well with objective health status. Further tests of the profile are now taking place on younger groups of subjects.
Affective Symptoms↗
Respiratory indicators.
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Environmental Pollutants↗
[Health indices].
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Activities of Daily Living↗
Association between clinical and subjective indicators of oral health status in an older adult population.
Since the mid-1970s a number of investigators have developed measures of the extent to which oral disorders compromise functional, social and psychological well-being. They have also examined the associations between clinical indicators of oral health status and these subjective indicators. In general, these associations have been inconsistent and weak. One reason for this might be that the subjective indicators employed were rudimentary and insensitive to the health outcomes of oral disorders. The development of the Oral Health Impact Profile, a more sophisticated measure of the health outcomes of oral disorders, provided a method to examine this hypothesis. Using data from an oral health survey of older adults, we examined the associations between OHIP scores and a variety of clinical indicators of tooth loss, caries and periodontal disease. Even with this measure the associations were predominantly weak, the strongest of the correlations being 0.53. We also examined the influence of personal and sociodemographic characteristics on the relationship between tooth loss and its psychosocial outcomes. Five variables reflecting expectations and resources explained as much variance in OHIP scores as did the number of missing teeth. This analysis illustrates the essential distinction between disease and health and the way in which measures of oral health can be used to pursue fundamental issues in behavioural science and health services research.
Aged↗
Sentinel health events as indicators of unmet needs.
It is vitally important to be able to assess the impact of the health care system on the populations it serves. This paper explores whether sentinel health events--negative health states, such as death, disability, and disease, that might have been avoided given current medical and public health knowledge and technology--can be used as sociomedical indicators to assess levels of unmet needs and to evaluate health system performance. Using hospital discharge data, the occurrence of sentinel health events in New York State and differences among population subgroups are examined. Among hospitalized residents of New York State in 1983, more than 17,000 deaths occurred that were possibly avoidable. More than 336,000 instances of disease were found that were potentially preventable. Significantly higher rates and ratios for many sentinel events were found among blacks, Medicaid recipients, and users of public hospitals than were found for comparison groups. The sentinel events approach proved to be useful and practical. However, refinements and adaptations of the sentinel events method are needed, including the development of one or more smaller sets of indicators--tracer sentinel events--that can be used to profile aspects of health status and the health system.
Black or African American↗
Re: "principal component analysis of four health indicators and construction of a global health index".
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Health Status Indicators↗
Differentiating positively and negatively health oriented Finnish university students by discriminant analyses.
Dental health practices among Finnish university students were studied in 1980. In order to obtain more information about the factors associated with different health status this problem was studied using linear discriminant analyses. 360 students were separately classified into fifths according to increasing individual VPI, GBI and DMFS index scores. According to the classification, the students of the two first fifths with lowest mean index scores were combined in the positively health oriented group. The students with low VPI and GBI index scores reported that they brushed their teeth most frequently. Also the good results of the dip-slide method for counting salivary lactobacilli correlated well with the low VPI and DMFS index scores. In the discriminant analysis toothbrushing frequency was the most important single variable related to a good VPI score. By a computer method, 64% of the students were found to be correctly placed in the group of the positively health oriented. The corresponding percentage for the negatively oriented was 69%. The most important single variable related to good GBI and DMFS scores was subjective estimation of condition of dentition. According to GBI score the method correctly placed 57% of the students in the group of the positively and 69% in the group of the negatively health oriented. The respective percentages for DMFS-index were 65% and 68%. The predictor variables failed to make an important contribution toward explaining the great variations in the oral health status indicators.
Attitude to Health↗
The development of a state-level health manpower database using an employer-based survey: a pilot project.
State health care reform may provide a better approach to meeting the health care needs of rural communities than does federal reform because the planning is closer to the needs of local communities. However, state health reform requires a health manpower database (along with other data) that includes all health occupations and such databases are often nonexistent. This study reports on one element of such a database--a survey of a wide range of rural health care employers covering the full range of health occupations in Alabama. Information on current and future employment of the most significant health occupations is reported here. It was found that the greatest numbers of new health personnel employees needed in the future were, in descending order, nursing assistants, registered nurses, licensed practical nurses, radiological technicians, specialist physicians, nurse practitioners, physical therapists, primary care physicians, and respiratory care therapists. While an employer survey has limitations and should be supplemented by data on community needs and health status indicators, it does provide useful information for planning educational programs to prepare health personnel.
Alabama↗