Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Indication”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 541 records · Page 30Linked to original sources
PubMed2005

Use of productivity and financial indicators for monitoring performance in academic radiology departments: U.S. nationwide survey.

PURPOSE: To determine how productivity- and finance-related indicators are used by radiology departments to evaluate departmental performance. MATERIALS AND METHODS: The study met the criteria to be exempt from institutional review board approval. All subjects were informed of the purpose of the study and that their questionnaire responses would be kept confidential. For the study, a survey was sent to 132 members of the Society of Chairmen of Academic Radiology Departments (SCARD) nationwide. The survey was designed to (a) assess organizational information about hospital and radiology departments, (b) determine the types and mean numbers of productivity and financial indicators used by radiology departments, (c) determine how these indicators are used to influence departmental productivity, and (d) assess the reference-standard goals with which each indicator value was compared. A total of 77 variables were studied. Summary statistics, Spearman rank correlation coefficient, and chi2 analyses were performed. RESULTS: The response rate was 42% (55 of 132 surveyed SCARD members). The mean number of productivity indicators used by radiology departments was 4.55 +/- 2.56 (standard deviation), while the mean number of financial indicators used was 2.89 +/- 1.99. Twenty-two (40%) of the 55 responding departments used productivity indicators to monitor and provide feedback to radiologists, hospital leaders, and technical staff members for improved productivity, but only 11 (20%) departments used these indicators to compare personnel performances against specific productivity standards. The most frequent goal (of seven [13%] responding departments) of using the indicators was to increase the examination volume from the previous year by 5%-10%. CONCLUSION: Academic radiology departments across the United States do not use a standardized set of productivity and financial indicators to measure departmental performance. Examination volume is the most frequently used productivity indicator, whereas general expenses are commonly used as indicators of financial status.

Chi-Square Distribution↗
PubMed2003

Community/hospital indicators in South African public sector mental health services.

BACKGROUND: The need to balance resources between community and hospital-based mental health services in the post-deinstitutionalisation era has been well-documented. However, few indicators have been developed to monitor the relationship between community and hospital services, in either developed or developing countries. There is a particular need for such indicators in the South African context, with its history of inequitable services based in custodial institutions under apartheid, and a new policy that proposes the development of more equitable community-based care. Indicators are needed to measure the distribution of resources and the relative utilisation of community and hospital-based services during the reform process. These indicators are potentially useful for assessing the implementation of policy objectives over time. AIMS OF THE STUDY: To develop and document community/hospital indicators in public sector mental health services in South Africa. METHODS: A questionnaire was distributed to provincial mental health coordinators requesting numbers of full-time equivalent (FTE) staff who provide mental health care at all service levels, annual patient admissions to hospitals and annual patient attendances at ambulatory care facilities. The information was supplemented by consultations with mental health coordinators in each of the 9 provinces. Population data were obtained from preliminary findings of the 1996 census. The community/hospital indicator measuring staff distribution was defined as the ratio of staff employed in community settings to all staff, expressed as a percentage. The community/hospital indicator measuring patient service utilisation was defined as the ratio of the annual ambulatory care attendance rate per 100,000 population to the sum of this rate and the annual hospital admission rate per 100,000 population, expressed as a percentage. RESULTS: Of psychiatric public sector staff, 25% are located in community settings in South Africa (provincial range: 11-70%). If hospital outpatient services are included in the definition of ' 'hospital' ', this figure is reduced to 17% (provincial range: 3-56%). In terms of service utilisation, 66% of patient contacts with mental health services occur through ambulatory care services in South Africa (provincial range: 44-93%). DISCUSSION: Community/hospital staff distribution indicates an overemphasis on centralised hospital-based care in most provinces and inadequate hospital care in certain provinces. Patterns of patient service utilisation indicate an over-reliance on central hospital-based services and substantial unmet need. The findings draw attention to problems in information systems for mental health care in South Africa. IMPLICATIONS FOR HEALTH POLICIES: The community/hospital indicators developed for this study form a useful measure for assessing the implementation of mental health policy over time. For the South African context, the community/hospital indicators are a measure of the extent of resource redistribution from hospital to community services and changing patterns of service utilisation over time. Currently, patterns of resource distribution and service utilisation are inconsistent with government policy. IMPLICATIONS FOR FURTHER RESEARCH: Further research is needed into the development of mental health information systems, refining service indicators and improving methodologies for assessing the implementation of mental health policies in service delivery.

Cross-Sectional Studies↗
PubMed1995

Relationships between biochemical abnormalities and anthropometric indices of overweight, adiposity and body fat distribution in Japanese elementary school children.

OBJECTIVE: To determine the anthropometric indices linked to the biochemical risk factors for atherosclerosis in Japanese obese elementary school children, ages ranging from 6 to 12 years. DESIGN: Cross-sectional study of obese children based on fasting blood samples. SETTING: Outpatient clinic of University Hospital. SUBJECTS: 65 consecutive patients with simple obesity (38 boys and 27 girls), and age-matched controls, 184 boys and 205 girls. MAIN OUTCOME MEASURES: Percent obesity and body mass index as indices of being overweight; percent body fat and the sum of four skinfold thicknesses as indices of adiposity; waist-to-hip circumference ratio and waist-to-thigh circumference ratio as indices of body fat distribution. The anthropometric indices were standardized by calculating standard deviation scores based on data from control children. RESULTS: In the obese boys, all six anthropometric indices studied correlated closely with serum biochemical indices, and strong correlations were observed among the indices of overweight, adiposity and body fat distribution. In contrast, only the indices of body fat distribution, not those of overweight or of adiposity, were correlated with serum biochemical indices in the obese girls. No relationship was found between the indices of body fat distribution and the other anthropometric indices in the obese girls. Thus, the profile of the obese girls differed from that of their male counterparts. CONCLUSION: The results suggest that body fat distribution is related to certain biochemical complications of childhood obesity, and that androgyny in fat patterns induces metabolic derangements in children.

Adipose Tissue↗
PubMed1997

Quantitative estimation of errors in the indicator dilution measurement of extravascular lung water.

OBJECTIVE: To assess the accuracy of the diffusible indicators heavy water and thermal indicator in the measurement of extravascular lung water (EVLW). DESIGN: Cardiac output (CO), mean transit time and EVLW for the two diffusible indicators were measured. CO for indocyanine green, gravimetric EVLW and the calculated mean transit time for a diffusible indicator were used as independent reference variables. CO, mean transit time and EVLW for the two diffusible indicators were compared to the reference variables and the percentage error for each measured variable was calculated for each bolus injection. SETTING: 6 sheep with healthy lungs and 6 with pulmonary oedema in a research laboratory. INTERVENTIONS: CO was altered with positive end-expiratory pressure and dobutamine. MEASUREMENTS: All indicators were given together in a bolus through a central venous line. Indicators were detected simultaneously in the aorta, and CO, mean transit time and EVLW were measured. EVLW was measured gravimetrically (EVLWgrav) postmortem. RESULTS: In the combination of a low CO and a large distribution volume, heavy water and thermal indicator produced a large number of slow wash-out curves. These curves were abolished from further analysis. The mean errors in CO and mean transit time for heavy water were close to zero and independent of the distribution volume; the product EVLW was close to EVLWgrav. The mean error in thermodilution CO measured in the aorta was close to zero but dependent on the distribution volume. The mean error in mean transit time for the thermal indicator was 36% and dependent on the distribution volume. Their product EVLW overestimated EVLWgrav by 70%. CONCLUSIONS: The results obtained for heavy water confirmed the theoretical basis of the indicator dilution method. The mean transit time for the thermal indicator was not proportionate to its distribution volume. The magnitude of this error prevents the calculation of an anatomically defined EVLW using a catheter-mounted thermistor in the aorta.

Analysis of Variance↗
PubMed2005

Development and face validity of explicit indicators of appropriateness of long term prescribing.

OBJECTIVES: To develop a set of explicit and operationalisable indicators of appropriate prescribing and assess their face validity using clinical pharmacists practising in secondary and primary care. METHOD: Appropriateness indicators were derived from the literature, applied to data in the hospital clinical records of all newly prescribed long-term drugs for 50 randomly selected patients, further refined and then applied to another 25 randomly selected patients. A pre-piloted postal questionnaire was sent to 200 hospitals and primary care pharmacists, asking them to assess the indicators as to their importance for the assessment of appropriateness of long-term prescribing initiated in hospitals. RESULTS: Fourteen indicators were developed and piloted. Of the 16 original indicators, 5 were discarded, as they were unable to be operationalised, and 2 were subdivided to reflect the routinely available data. Eighty-six pharmacists with individual patient-focussed clinical duties took part in the assessment of the face validity (response rate 43%). Eleven indicators achieved a median importance rating of 1 (very important), and three indicators a median importance rating of 2 on a 5-point scale. The three most important indicators overall were "indication included in discharge summary", "questionable high-risk therapeutic combination" and "hazardous drug-drug combination". CONCLUSION: It was possible to develop and operationalise 14 indicators of the appropriateness of long-term prescribing commenced in hospital practice, all of which were considered to have face validity by an expert panel of clinical pharmacists. The development of these explicit indicators highlighted the incompleteness of the patient's record. Further work is needed to assess their validity and reliability, before their use in research or audit can be recommended.

Aged↗
PubMed2006

Reproductive health indicators in the European Union: The REPROSTAT project.

Our objective was to develop a set of indicators for monitoring and describing reproductive health in the European Union (EU) that reflect common concerns of the different Member States. Ideally, the indicators would possibly draw upon existing data sources. The REPROSTAT project: (i) conducted a review of existing recommendations on reproductive health indicators; (ii) suggested a set of initial indicators in consultation with representatives from relevant outside agencies and organisations; and (iii) invited 200 reproductive health experts throughout Europe to review the provisional set of indicators. The feasibility of using the REPROSTAT indicators was tested for two countries, Italy and Germany. A final set of 13 core indicators was developed, as well as another recommended indicator and four that needed further development. The pilot use of the indicators in Italy and Germany provided useful information about availability of data in different Member States. The REPROSTAT project developed a set of reproductive health indicators believed to be of relevance for planning, prevention, and caring within the EU. Further, harmonisation of data from different Member States will be needed if the benefits of these indicators are to be fully realised.

Abortion, Induced↗
PubMed2005

Pharmacy-specific quality indicators for asthma therapy.

BACKGROUND: Lack of appropriate drug therapy in asthma patients is a recognized quality problem leading to preventable emergency room visits, hospitalizations, or death. While indicators measuring pharmacotherapy quality on the level of prescribers and third party payers are widely used, no such indicators exist for pharmacies. OBJECTIVE: This study aimed to (1) develop quality indicators for asthma care applicable to retail pharmacies, (2) estimate the prevalence of inappropriate asthma drug therapy, and (3) explore variation in the quality of care across pharmacies. METHODS: We present a descriptive analysis of automated patient-specific dispensing data from February 1, 2000 to January 31, 2001 of beta-agonists and anti-inflammatory agents with a Food and Drug Administration-approved indication for asthma. Two quality indicators of potentially inappropriate drug therapy were applied: (1) the proportion of patients who obtained more than a 360-day supply (assuming maximum acceptable daily dose) of short-term beta-agonists (SABA) including all inhaler types, inhaler solutions, and syrups during the 12-month study and (2) the proportion of patients with 2 consecutive early refills of defined SABAs. Indicator values with 95% confidence intervals are reported for each pharmacy. RESULTS: Pharmacies had an average of 328 (range 169-534) patients who received SABAs. An average of 11 patients per pharmacy (3.4% of all patients who received SABAs) met the indicator 1 definition. The second indicator identified 8.2% (27) patients per pharmacy as short-term SABA overusers (range 3.9-11.9%). Of these, 48% did not receive any anti-inflammatory agents during the time frame when SABA overuse occurred. CONCLUSION: Application of drug therapy quality indicators at the level of individual pharmacies using dispensing data is feasible and identifies opportunities for quality improvement. Indicator 2 is most appropriate for daily practice, because it allows for timely identification of potentially uncontrolled patients, and offers a balance between indicator sensitivity and positive predictive value.

Adrenergic beta-Agonists↗
PubMed2006

Measuring process of arthritis care: the Arthritis Foundation's quality indicator set for rheumatoid arthritis.

OBJECTIVE: To describe the scientific evidence that supports each of the explicit process measures in the Arthritis Foundation's Quality Indicator Set for Rheumatoid Arthritis. METHODS: For each of the 27 measures in the Arthritis Foundation's Quality Indicator set, a comprehensive literature review was performed for evidence that linked the process of care defined in the indicator with relevant clinical outcomes and to summarize practice guidelines relevant to the indicators. RESULTS: Over 7500 titles were identified and reviewed. For each of the indicators the scientific evidence to support or refute the quality indicator was summarized. We found direct evidence that supported a process-outcome link for 15 of the indicators, an indirect link for 7 of the indicators, and no evidence to support or refute a link for 5. The processes of care described in the indicators for which no supporting/refuting data were found have been assumed to be so essential to care that clinical trails assessing their importance have not, and probably never will be, performed. The process of care described in all but 2 of the indicators is recommended in 1 or more practice guidelines. CONCLUSION: There are sufficient scientific evidence and expert consensus to support the Arthritis Foundation's Quality Indicator Set for Rheumatoid Arthritis, which defines a minimal standard of care that can be used to assess health care quality for patients with rheumatoid arthritis.

Arthritis, Rheumatoid↗
PubMed1984

An evaluation of errors in the determination of blood flow by the indicator fractionation and tissue equilibration (Kety) methods.

In this report, the effects of various errors and plasma time courses of indicator concentration on the accurate determination of cerebral blood flow (F) are theoretically analyzed for the tissue equilibration and the indicator fractionation techniques. For the indicator fractionation technique, the impact of sample timing and tissue assaying errors and of indicator backflux were examined; for the tissue equilibration method, errors in the value of the partition coefficient (lambda), sample timing, and tissue assaying were considered. The recommended ways to decrease the effects of errors in the indicator fractionation technique are to administer the indicator by an intravenous bolus and to sample the tissue about 10 s thereafter. Possible errors in the assessment of F by the tissue equilibration technique are diminished by using an indicator infusion schedule which yields a continuous rise in arterial concentration and by selecting a 30-s experiment duration. Surprisingly, the impact of sample timing errors is greater on the determination of F with the tissue equilibration method than with the indicator fractionation technique. For the chosen plasma time courses, there is always a backflux error in an indicator fractionation estimation of F, and this error increases as the flow rate increases. Thus, provided the sample timing and tissue assay errors are small and the value of lambda is known, the tissue equilibration method is the more accurate of the two. If lambda is unknown, then the indicator fractionation technique should be used. In many cases, the indicator fractionation method will provide as accurate an estimate of F as will the tissue equilibration method.

Animals↗
PubMed2002

Measure for measure: the quest for valid indicators of non-fatal injury incidence.

In this edition of Public Health, McClure and colleagues report on research that considered the criterion validity of indicators based on serious long bone fracture and length of stay in hospital. They found that neither were sensitive or specific indicators for serious injury as defined by an Injury Severity Score (ISS) of 16 or more. They contend that their study findings ' em leader strongly support a return to a measure similar in intent to that encapsulated in the original UK Green Paper em leader '. We contend that their analysis does not provide any empirical evidence to support their view that there should be a return to the Green Paper: Our Healthier Nation indicator. Furthermore, we consider the analyses that they carry out to validate both the Saving Lives: Our Healthier Nation and the serious long bone fracture indicators are flawed. We agree that national (or state) indicators are very influential. They encourage preventive action and resource use aimed at producing favourable changes to these indicators. However, each of the four non-fatal indicators considered in their analysis have problems. Formal validation of existing indicators is necessary and the following aspects of validity should be addressed: face; criterion; consistency; and completeness and accuracy of the source date. Taking into account the current national data systems in England, possible options for one or more national non-fatal unintentional injury indicators have been proposed in our paper. Furthermore, the International Collaborative Effort on Injury Statistics (ICE) Injury Indicators Group is about to embark on the development of a strategic framework for the development of valid indicators of non-fatal injury occurrence.

Evidence-Based Medicine↗
PubMed2003

Patient satisfaction data as a quality indicator: a tale of two emergency departments.

OBJECTIVE: Patient satisfaction is a commonly measured indicator of quality emergency care. However, the existing empirical literature on emergency department (ED) patient satisfaction provides little guidance on how to analyze, interpret, and use data obtained in the clinical setting. Using two EDs as examples, the authors describe practical strategies designed to identify priority areas for potential improvement. METHODS: The authors used a cross-sectional, observational design. All patients who presented for emergency care during the designated time periods were eligible. Patients were randomly selected, contacted by telephone, and surveyed using three measures of global satisfaction, 23 perceived quality-of-care indicators, and six perceived wait times. Descriptive statistics were calculated. Comparisons were made of each of the perceived care and wait time indicators against explicitly defined acceptability criteria to determine satisfiers/dissatisfiers. Each indicator was correlated with the three global satisfaction indices. The authors integrated results obtained from applying the acceptability criteria with those obtained from the correlations to yield priority indicators for remediation and maintenance strategies. RESULTS: For hospitals A and B, respectively, 15 (52%) and 16 (55%) of perceived care and wait time indicators failed to meet acceptability criteria. Using the correlations with overall satisfaction, the authors further narrowed the priority areas for remediation to six indicators for hospital A and three indicators for hospital B. One maintenance indicator was revealed for hospital A and four for hospital B. CONCLUSIONS: A combination of applying explicit acceptability criteria to descriptive statistics and using correlation coefficients with overall satisfaction can help to maximize the usefulness of patient satisfaction data by uncovering priority areas. These priority areas were broken down into maintenance and remediation indicators and were found to vary considerably depending on the hospital in question. Such strategies can help to refine performance improvement efforts by targeting those domains with the greatest impact on overall satisfaction.

Adolescent↗
PubMed2003

Can health care quality indicators be transferred between countries?

OBJECTIVE: To evaluate the transferability of primary care quality indicators by comparing indicators for common clinical problems developed using the same method in the UK and the USA. METHOD: Quality indicators developed in the USA for a range of common conditions using the RAND-UCLA appropriateness method were applied to 19 common primary care conditions in the UK. The US indicators for the selected conditions were used as a starting point, but the literature reviews were updated and panels of UK primary care practitioners were convened to develop quality indicators applicable to British general practice. RESULTS: Of 174 indicators covering 18 conditions in the US set for which a direct comparison could be made, 98 (56.3%) had indicators in the UK set which were exactly or nearly equivalent. Some of the differences may have related to differences in the process of developing the indicators, but many appeared to relate to differences in clinical practice or norms of professional behaviour in the two countries. There was a small but non-significant relationship between the strength of evidence for an indicator and the probability of it appearing in both sets of indicators. CONCLUSION: There are considerable benefits in using work from other settings in developing measures of quality of care. However, indicators cannot simply be transferred directly between countries without an intermediate process to allow for variation in professional culture or clinical practice.

Cross-Cultural Comparison↗
PubMed2004

The use of prescribing indicators to measure the quality of care in psychiatric inpatients.

OBJECTIVE: To explore the potential for using seven prescribing indicators, individually and in combination, to measure prescribing quality for hospitalised psychiatric patients. DESIGN AND SETTING: The dataset included full details of all psychotropic medication prescribed over a 24 hour period to 4192 inpatients in 49 British mental health services in 1998. RESULTS: Despite the large size of the dataset, for three of the indicators 20 services had fewer than 10 eligible patients. There was great variation between services in indicator scores. Correlations between standardised indicator scores and total score (which omitted the indicator concerned) were above 0.3 for all but one of the indicators. Cronbach's alpha was 0.73 when this outlying indicator was removed. CONCLUSIONS: There are no routinely collected prescribing data that allow for the quality of prescribing for psychiatric patients to be monitored. Six of the seven indicators measured during this census survey appear to reflect a common attribute of the services, and the analysis suggests that they might be combined to give an overall measure of service performance. There was, however, no relationship between performance on the seventh indicator and performance on the other six. This raises questions about case mix and service level factors that might influence indicator scores independent of prescriber decision making. The psychometric properties of prescribing indicators (occurrence rates, consistency over time) are unknown.

Drug Prescriptions↗
PubMed2004

Presynaptic calcium measurements at physiological temperatures using a new class of dextran-conjugated indicators.

Presynaptic calcium (Ca(pre)) has been studied extensively because of its role in triggering and modulating neurotransmitter release. Although calcium regulation and calcium-driven processes can be strongly temperature dependent, technical difficulties have limited most studies of Ca(pre) to temperatures well below the physiological range. Here we assessed the use of membrane-permeant acetoxymethyl (AM) indicators and dextran-conjugated indicators for measuring Ca(pre) at physiological temperatures. A comparison of these two types of indicators loaded into parallel fibers of rat cerebellar slices revealed striking differences. AM indicators were rapidly extruded from axons and presynaptic terminals and therefore cannot be used for long-term measurements at high temperatures. In contrast, dextran-conjugated indicators were retained within parallel fibers and are therefore well suited to measuring Ca(pre) at physiological temperatures. The limited number of dextran indicators available prompted us to synthesize three new indicators that show peak emission in the red (575-600 nm). These indicators allow for simultaneous use of multiple calcium indicators that can be readily distinguished on the basis of excitation and emission wavelengths, use of excitation and emission wavelengths that are relatively insensitive to tissue autofluorescence, and measurements in systems with expression of green fluorescent protein (GFP). Thus we find that dextran-conjugated indicators are well suited to long-term recordings of Ca(pre) at physiological temperatures and that the development of new red indicators greatly extends their utility.

Animals↗
PubMed2005

[Development of performance measure indicators in hospital nursing units].

PURPOSE: The purpose of this study was to develop performance measure indicators for hospital nursing units based on a Balanced Scorecard (BSC). METHOD: This study was a methodological study. The development process consisted of 3 stages. The first stage was setting up strategies for nursing units from a nursing department's mission and vision. The second stage was developing performance measure indicators after a validity check. The third stage was modifying developed performance measure indicators and classifying them. RESULTS: 7 strategies were set up according to 4 perspectives of a BSC. 15 performance measure indicators for hospital nursing units were developed, and the indicators were divided into 8 independent indicators and 7 shared indicators according to the degree of performance responsibility. In addition, they were classified into two groups, 7 leading indicators and lagging indicators. CONCLUSIONS: The result of this study suggests that performance measure indicators for hospital nursing units provide a framework and method for nursing organizations' performance management. Also, the developed indicators are expected to provide valuable information for successful organization management.

Humans↗
PubMed2002

Limitations of Health Insurance Commission (HIC) data for deriving prescribing indicators.

OBJECTIVES: To derive indicators of quality prescribing by Australian general practitioners based on Health Insurance Commission (HIC) data and assess the influence of incomplete capture of data on under-copayment drugs on the validity of these indicators. DESIGN: Two expert groups proposed prescribing indicators that can be derived from aggregate prescribing data, and which reflect important clinical or cost-effectiveness issues. Indicators were examined using HIC data and compared with national prescribing trends over time using Australian Statistics on Medicines. The effect of incomplete data capture on indicator interpretation was examined by stratifying GPs into five strata based on the proportion of concession card holders in their practice. PARTICIPANTS: Approximately 14,000 Australian GPs providing > or = 1500 Medicare services per year. MAIN OUTCOME MEASURES: Measures of prescribing for individual GPs (based on HIC data 1993-1997). RESULTS: Forty-three potentially useful indicators were identified. These covered a fairly narrow range of prescribing activities and many required additional clinical information for interpretation. Indicators based on prescribing rates gave a misleading picture of prescribing trends where the extent of HIC data capture changed over time. Indicators expressed as ratios that reflected choice of agent within a drug class were less affected by incomplete data capture. CONCLUSIONS: Indicators of quality prescribing can be derived from HIC data. However, indicators for under-copayment drugs that represent prescribing rates may unfairly classify doctors practising in areas of socioeconomic disadvantage or high morbidity as "high prescribers". Ratio indicators are more robust, and may be more valid prescribing measures. If HIC data are to be used to monitor the quality of prescribing, data on all prescriptions dispensed will be needed.

Australia↗
PubMedDate not supplied

A strategy for developing environmental health indicators for rural Canada.

Our understanding of and ability to describe rural health conditions can be considerably enhanced by the use of rural health indicators which allow us to compare rural and nonrural areas or areas differentially located on the urban-rural continuum in terms of various health conditions. However, while health indicators abound, there are very few that can be used to describe the health conditions of rural Canada. This paper discusses the concepts of health in a rural context and adopts a broad definition of health that goes beyond the mere absence of disease or impairment. We propose five broad categories of health indicators: health status indicators, health determinant indicators, health behaviour indicators, health resource indicators, and health service utilization indicators. The most commonly used health indicators in Canada and the datasets from which they are derived are examined in order to assess their applicability to "communities" or "regions". This review highlights the strengths and limitations of various datasets and indicators and their applicability to the "community" and "regional" scale for rural environments. Finally, challenges in data availability and use are discussed as they relate to rural health indicator development.

Canada↗
PubMed1995

Developing indicators for environment and health.

This article demonstrates the need for indicators in the policy-making process and presents some of the current work on developing environmental indicators at the international, national and local levels. The paucity of indicators to demonstrate relationships between environment and health is outlined and a causal chain for physical pollutants--from source activity to emission, concentration and exposure--is presented. While indicators can be developed at each of these stages, indicators from earlier in the chain reflect processes which can more readily be controlled by policy; data is also more readily available for these indicators, yet only the later indicators are likely to provide a reliable guide to human exposure. A survey of 26 indicator projects from around the world yielded 8 sets which are in use and for which data exists. These were found to be only partially health-related and heavily weighted towards the source activity indicator category. Their utility as reliable indicators of human exposure is therefore seriously open to doubt and there is consequently a need to develop indicators specifically to assess environmental and health relationships.

Bias↗