[FROM THE HISTORY OF THE DISPENSARY SERVICE FOR SCIENTIFIC WORKERS IN THE USSR. (BASED ON DATA FROM THE CENTRAL GOVERNMENT ARCHIVES OF THE OCTOBER REVOLUTION OF THE USSR)].
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Results for “data governance”
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.
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Data page: patient safety & governance.
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Governing Board↗
Final regulations are published governing the National Practitioner Data Bank.
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Health Occupations↗
Government issues 1976 income data based on tax returns.
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Canada↗
National data sources on the care and outcomes of patients with community acquired pneumonia.
Despite improved understanding and treatment of community acquired pneumonia (CAP), variations in clinical practice and patient outcomes still exists, resulting in excess healthcare dollars spent and decreased patient satisfaction. The use of treatment and outcomes research data can help providers improve their methods and standardize techniques to control costs and provide the best care for their patients. To better understand the utility and capabilities of this research, this article will compare several administrative and clinical databases. Two, data sources in particular, the EPI-Q Inc. CAP-Compare database and the University HealthSystem Consortium's (UHC) CAP Benchmarking Program contain clinical and utilization data specific to CAP. In addition there are several government and non-government sponsored data sources that include administrative data on many diagnosis including CAP. These include: Healthcare Benchmarking Systems International's EXPLORE database, the Center for Healthcare Industry Performance Studies database, the National Center for Health Statistics'--National Hospital Discharge Survey, and the Medicare Provider Analysis and Review data files.
Benchmarking↗
Outcomes of a randomized controlled trial of a clinical pharmacy intervention in 52 nursing homes.
AIMS: To evaluate whether a year long clinical pharmacy program involving development of professional relationships, nurse education on medication issues, and individualized medication reviews could change drug use, mortality and morbidity in nursing home residents. METHODS: A cluster randomised controlled trial, where an intervention home was matched to three control homes, was used to examine the effect of the clinical pharmacy intervention on resident outcomes. The study involved 905 residents in 13 intervention nursing homes and 2325 residents in 39 control nursing homes in south-east Queensland and north-east New South Wales, Australia. The outcome measures were: continuous drug use data from government prescription subsidy claims, cross-sectional drug use data on prescribed and administered medications, deaths and morbidity indices (hospitalization rates, adverse events and disability indices). RESULTS: This intervention resulted in a reduction in drug use with no change in morbidity indices or survival. Differences in nursing home characteristics, as defined by cluster analysis with SUDAAN, negated intervention-related apparent significant improvements in survival. The use of benzodiazepines, nonsteroidal anti-inflammatory drugs, laxatives, histamine H2-receptor antagonists and antacids was significantly reduced in the intervention group, whereas the use of digoxin and diuretics remained similar to controls. Overall, drug use in the intervention group was reduced by 14.8% relative to the controls, equivalent to an annual prescription saving of A64 dollars per resident (approximately 25 pound sterling). CONCLUSIONS: This intervention improved nursing home resident outcomes related to changes in drug use and drug-related expenditure. The continuing divergence in both drug use and survival at the end of the study suggests that the difference would have been more significant in a larger and longer study, and even more so using additional instruments specific for measuring outcomes related to changes in drug use.
Age Distribution↗
ESTprep: preprocessing cDNA sequence reads.
MOTIVATION: High accuracy of data always governs the large-scale gene discovery projects. The data should not only be trustworthy but should be correctly annotated for various features it contains. Sequence errors are inherent in single-pass sequences such as ESTs obtained from automated sequencing. These errors further complicate the automated identification of EST-related sequencing. A tool is required to prepare the data prior to advanced annotation processing and submission to public databases. RESULTS: This paper describes ESTprep, a program designed to preprocess expressed sequence tag (EST) sequences. It identifies the location of features present in ESTs and allows the sequence to pass only if it meets various quality criteria. Use of ESTprep has resulted in substantial improvement in accurate EST feature identification and fidelity of results submitted to GenBank. AVAILABILITY: The program is freely available for download from http://genome.uiowa.edu/pubsoft/software.html
Algorithms↗
Healthcare reform: past and future.
PURPOSE: To review changes in the healthcare delivery system and project the challenges that practitioners and consumers will face in a reformed environment. DATA SOURCES: Professional journals and books, print media, and government releases. DATA SYNTHESIS: Analysis of projected reform plans, discussions of issues related to complex social, economic, and political factors, and considerations for practice changes for oncology nurses. CONCLUSIONS: The pending dominance of healthcare delivery through managed-care systems will challenge oncology care providers and consumers. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses must identify the opportunities, master the challenges, and adapt to the trends of the reformed healthcare system. The delivery of long-term care to senior citizens, patients with AIDS, and individuals from diverse cultures will shift to more community, ambulatory, and rural managed-care settings. Oncology nursing practice in these environments raises questions about prevention and screening, diagnosis, treatment, follow-up, alternative care, and research. Oncology nurses, especially advanced practice nurses, will play a pivotal role in reshaping the delivery of patient care and in designing the future of their profession.
Delivery of Health Care↗
The impact of research governance in healthcare and higher education organizations.
AIM: This paper reports a study exploring the impact and implementation of research governance in the North West region of England. BACKGROUND: In 2001, the UK Government launched a framework to ensure the governance of research within the National Health Service. Whilst this framework was undoubtedly geared towards improving the standards and practice of research, concerns have been raised in the academic literature about the potentially negative impact on future research. METHODS: A mixed method approach, using questionnaires (n = 350), semi-structured interviews and focus groups with a volunteer sample, was used to explore research staff perspectives about research governance. Survey data were analysed using Microsoft Excel, and a thematic analysis was used to elicit themes from the semi-structured interviews. The study lasted for 12 months and used a range of study sites, giving insight into potentially different experiences or approaches to implementing the research governance framework. FINDINGS: Questionnaire data revealed a good level of awareness about the Research Governance Framework. However, a range of concerns was also raised, such as the increased workload associated with the research governance application process and lack of transparency about the process. Five themes emerged from the focus groups: control, epistemology, organizational issues, impact on teaching and learning, and ambiguity in the definitions of research and audit. CONCLUSIONS: Recommendations emerging from the study include the promotion of transparent research governance guidelines for practitioners, and the need for staff education about governance processes and greater parity between organizations in research governance processes.
England↗
Information governance standards for managing e-health information.
Integrity of patient information, from both a quality and a security perspective, is critical to patient care. In the UK, the information governance initiative of the National Health Service (NHS) provides a framework to monitor and control the management of confidential patient data. Information governance standards grew out of the Data Accreditation Programme, first proposed in the 1998 NHS document Information for Health. The Data Accreditation Programme was based on a three-stage assessment of data quality in acute hospitals. Stage one required internal review of policy and procedures for data input into computerized patient administration systems. Stage two involved an external audit to verify compliance with the standards. Stage three mandated audits of data outputs, focusing on clinical coding quality. Before stage three of the programme was fully implemented, the standards were incorporated into the information governance initiative, in which standards were expanded to include primary care and other health-care settings. These standards address many information management issues, including security and data quality, which are key concerns in telemedicine and e-health applications. Compliance is essential for the successful implementation of the NHS Care Records Service, which will allow sharing of electronically stored patient information across the UK.
Confidentiality↗
Core data set. Importance to health services research, outcomes research, and policy research.
Development of consistent health care information has been hampered by the lack of a core data set that contains clinical information. The Uniform Hospital Discharge Set was developed to record individual discharge profiles derived from hospital billing systems. Using that information, some states developed data repositories. Government and health insurers maintain databases of claims paid. The data are not consistent, not readily available, may not contain all encounters, and are financial, not clinical. Wide variance in number of procedures in different geographic regions, variability in mortality rates, and variance in expenditures for particular conditions have been identified from those databases. However, they contain little information to assess the 'best' clinical practices regarding patient outcome. We describe specific limitations of current data sets and how health services research, outcomes research, and policy research, could be improved by a core data set, as well as recommendations about a core data set.
Data Collection↗
[Epidemiologic features of subacute sclerosing panencephalitis from clinical data of patients receiving a public aid for treatment].
In 1999, clinical data of 125 patients with subacute sclerosing panencephalitis (SSPE) were obtained by the Research Committee from local prefectural governments. The data were made by physicians treating the patients, and were submitted to the governments when the patients applied for the aid. By analyzing the data, we observed the epidemiologic features of the disease in Japan, and discussed the availability of the data as the source of epidemiologic researches. Of the 125 patients, 66 were males and 59 were females. The distribution of age at onset had a peak in 5-14 years of age with the average of 10.3 years. Among the 109 cases in which the time of infection was obvious, more than 80% suffered from measles before 2 years of age, in agreement with the hypothesis that measles infection in young age is a risk factor of SSPE. The interval between measles and the onset of SSPE was between 5 and 10 years in most cases, with average of 8.8 years, median of 4.3 years, ranging from 2 months to 23.6 years. Because the data contain some problems, we have to observe the epidemiologic features of SSPE in Japan based on multiple data sources including this one, considering their advantages and disadvantages.
Adolescent↗
Communities and hospitals: social capital, community accountability, and service provision in U.S. community hospitals.
OBJECTIVES: The study related community social capital to the level of community accountability and provision of community-oriented services in U.S. community hospitals. STUDY SETTING: The sample included 1,383 community hospitals that participated in the 1997 American Hospital Association's (AHA) Hospital Annual and Governance Surveys. DATA SOURCES: (1) The 1997 AHA Annual Hospital Survey, (2) the 1997 AHA Hospital Governance Survey, (3) the DDB Needham Market Facts Survey, (4) the 1996 County Election Data File, and (5) the 1998 Area Resource File. RESEARCH DESIGN: The study used a mix of longitudinal and cross-sectional data. KEY FINDINGS: We identified two distinct indicators of social capital-community participation and voting participation. Community accountability in hospitals was unrelated to either indicator. Hospitals' provision of community-oriented health services was negatively associated with community participation but unrelated with voting participation. The interaction between voting participation and community representation on hospital governance was positively associated with community accountability and provision of community-oriented health services. CONCLUSION: Neither community participation nor voting participation was sufficient to influence hospital behavior. The positive finding associated with the interaction between voting participation and community representation on hospital governance underscored the importance of an active political culture in influencing hospital behavior, without which the installation of community representatives on hospital governance might be more symbolic than actually serving the health concerns of community residents.
Catchment Area, Health↗
State, local government conference discusses plan administration, data, cost control, wellness.
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Cost Control↗
[A consideration on the import of Chinese crude drugs of general use in the 2nd half of Taisho era (7): especially on the change of import volume and price of rhubarb].
Since most of the crude drug rhubarb was imported in the Taisho era, similarly to the Meiji era, it was possible to refer to the government statistic data by investigating and elucidating the import volume of the same in the treaty ports at that time. Upon examining the import status in the period from the late part of the Taisho era to the early part of Showa era (around 1920 to 1930), the following transitions were observed. 1) In 1923 (Taisho 12), the Kantoh earthquake happened and it attacked Yokohama where the function as main trade port was almost totally destroyed. ... 2) The earthquake happened just at the time when the tariff protectionism was increasingly promoted in every country. ... 3) Since the port of Yokohama, as trade port, was damaged by the earthquake at that time and the government import statistic data were limited to a partial summing-up, our investigation was referred to the statistic data at the ports of Osaka and Kobe. ...
China↗
Prescriptive authority for advanced practice nurses: current and future perspectives.
PURPOSE: To present an overview of the issues related to prescriptive authority and advanced practice nurses (APNs) in oncology. DATA SOURCES: Professional journals and books, print media, and professional and government releases. DATA SYNTHESIS: Discussion of issues related to complex political, educational, economic, and healthcare environmental factors. Strategies to achieve increased recognition for APN prescriptive authority include increasing APNs' knowledge about the effects of the political process on prescriptive authority, educating legislators and consumers, promoting standardization of pharmacology curricula, and encouraging formation of coalitions. CONCLUSIONS: Failure to pass a national healthcare plan, escalating managed-care markets, and the reform efforts of individual states to forge their own healthcare initiatives will challenge the APN's ability to practice and prescribe. IMPLICATIONS FOR NURSING PRACTICE: The subject of prescriptive authority highlights the controversies and debates that APNs encounter in a dynamic healthcare environment. These include the complexity of state-to-state regulations, non-nursing professions making key decisions regarding scope of practice and prescriptive authority, and the challenge for APNs to carve out new roles while overcoming state regulatory inconsistencies and market-reform barriers. If not resolved, these issues will continue to prevent qualified APNs from providing appropriate and comprehensive care to patients with cancer.
Drug Prescriptions↗
Billing third party payers for pharmaceutical care services.
OBJECTIVE: To describe the steps pharmacists must complete when seeking compensation from third party payers for pharmaceutical care services. DATA SOURCES: Government publications; professional publications, including manuals and newsletters; authors' personal experience. DATA SYNTHESIS: Pharmacists in increasing numbers are meeting with success in getting reimbursed by third party payers for patient care activities. However, many pharmacists remain reluctant to seek compensation because they do not understand the steps involved. Preparatory steps include obtaining a provider/supplier number, procuring appropriate claim forms, developing data collection and documentation systems, establishing professional fees, creating a marketing plan, and developing an accounting system. To bill for specific patient care services, pharmacists need to collect the patient's insurance information, obtain a statement of medical necessity from the patient's physician, complete the appropriate claim form accurately, and submit the claim with supporting documentation to the insurer. Although many claims from pharmacists are rejected initially, pharmacists who work with third party payers to understand the reasons for denial of payment often receive compensation when claims are resubmitted. CONCLUSION: Pharmacists who follow these guidelines for billing third party payers for pharmaceutical care services should notice an increase in the number of paid claims.
Centers for Medicare and Medicaid Services, U.S.↗
The endodontic workforce.
The amount of endodontic care provided in the US requires an understanding of the supply and demand for such care. The supply side includes the number and location of endodontists, type of provider, and productivity. The demand side consists of the changing demographics of the age groups that endodontists predominantly treat along with changes in their dental health. To address these issues, we have compiled and analyzed data from American Dental Association (ADA) with other sources such as US government census data and the National Health and Nutrition Examination Surveys (NHANES). From 1982 to 2002, the supply of endodontists increased at a rate greater than that observed with general practitioners or the other specialty areas. The growth of endodontists in relation to general practitioners is important. The latter are co-providers of endodontic care as well as a primary source for referral of patients to endodontists. Demographic and disease changes are likely to impact the need and demand for endodontic services. Endodontists' patients are generally between the ages of 25 and 64 yrs. Currently, the majority of endodontists' patients are members of the large baby boom generation who in 2000 ranged in age from their late 30s to their late 50s. During the next 20 yrs the Baby Boom generation will be replaced by the numerically smaller Generation-X cohort. This generation has experienced substantially less total caries than baby-boomers and they most likely will have fewer endodontic sequela as they age. A moderating factor that could partially offset the predicted decline in numbers of patients is the increased number of teeth that Generation-Xers are likely to retain. A flexible endodontic workforce strategy must assess the impending demographic and disease trends in relation to future growth rates of both endodontists and general practitioners.
Adult↗