Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Data Sources”

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 1,603 records · Page 89Linked to original sources
PubMed1982

Duplicate health insurance coverage: determinants of variation across states.

Although it is recognized that many people have duplicate private health insurance coverage, either through separate purchase or as health benefits in multi-earner families, there has been little analysis of the factors determining duplicate coverage rates. A new data source, the Survey of Income and Education, offers a comparison with the only previous source of state level data, the estimates from the Health Insurance Association of America. The R2 between the two sets is only .3 and certain problems can be traced to the methodology underlying the HIAA figures. Using figures for gross and net coverage, the ratio of total policies to people with private coverage ranges from .94 in Utah to 1.53 in Illinois. Measures of industry distribution, per capita income and employment explain a large portion of the variance, but it appears that these factors operate in opposite directions for group and non-group policies. Similar sociodemographic variables also explain net coverage. These findings have substantial implications for research and the structuring of employee health benefits.

Analysis of Variance↗
PubMed1999

The Danish registers of causes of death.

In 1875 registration of causes of death in Denmark was established by the National Board of Health, and annual statistics of death have since been published. Until 1970 the national statistics were based upon punched cards with data collected from the death certificates. Since then the register has been fully computerized and includes individual based data of all deaths occurring among all residents in Denmark dying in Denmark. Furthermore, a microfilm of all death certificates from 1943 and onward is kept in the National Board of Health. The Danish Institute for Clinical Epidemiology (DICE) has established a computerized register of individual records of deaths in Denmark from 1943 and onwards. No other country covers computerized individual based data of death registration for such a long period, now 54 years. This paper describes the history of the registers, the data sources and access to data, and the research based upon the registers, presenting some examples of research activities.

Adult↗
PubMed1999

The effects of managed care and prospective payment on the demand for hospital nurses: evidence from California.

OBJECTIVE: To examine the effects of managed care and the prospective payment system on the hospital employment of registered nurses (RNs), licensed practical nurses (LPNs), and aides. DATA SOURCES: Hospital-level data from California's Office of Statewide Health Planning and Development (OSHPD) Hospital Disclosure Reports from 1976/1977 through 1994/1995. Additional information is extracted from OSHPD Patient Discharge Data. STUDY DESIGN: Multivariate regression equations are used to estimate demand for nurses as a function of wages, hospital output, technology level, and ownership. Separate equations are estimated for RNs, LPNs, and aides for all daily services and for medical-surgical units. Instrumental variables are used to correct for the endogeneity of wages, and fixed effects are included to control for unobserved differences across hospitals. PRINCIPAL FINDINGS: HMOs are associated with a lower use of LPNs and aides, and HMOs do not have a statistically significant effect on the demand for RNs. Managed care has a smaller effect on nurse staffing in medical-surgical units than in daily service units as a whole. The prospective payment system does not have a statistically significant effect on nurse staffing. CONCLUSIONS: HMOs have affected nursing employment both because HMOs have reduced the number of discharges and because of a direct relationship between HMO penetration and the demand for LPNs and aides. Contrary to press reports, LPNs and aides have been affected more by HMOs than have registered nurses.

California↗
PubMed2000

Issues in determining cancer screening recommendations: who, what, and when.

PURPOSE/OBJECTIVES: To provide an overview of the issues involved in evaluating and choosing cancer screening guidelines. DATA SOURCES: Current epidemiologic literature. DATA SYNTHESIS: Screening is universally accepted as being important for cancer control. A number of organizations have developed cancer screening guidelines. However, agreement on who should be screened, with what tests, and at what ages and intervals is far from universal. Choice of screening guidelines may be influenced by differences in populations of interest and considerations of screening effectiveness. CONCLUSION: Directing patients toward appropriate screening tests and intervals requires attention to information about screening tests and to individual and institutional characteristics. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses should be aware of the various issues that influence cancer screening recommendations. Nurses advising patients about or developing cancer screening services must consider identifying both the patient population to be screened and factors influencing screening test effectiveness. This information then can be used to choose the most appropriate guidelines from those available. Consideration of the issues also can be applied as advances in screening evolve.

Guidelines as Topic↗
PubMed2000

Community orientation in hospitals: an institutional and resource dependence perspective.

OBJECTIVE: To conceptualize community orientation-defined as the generation, dissemination, and use of community health-need intelligence-as a strategic response to environmental pressures, and to test a theoretically justified model of the predictors of community orientation in hospitals. DATA SOURCES: The analysis used data for 4,578 hospitals obtained from the 1994 and 1995 American Hospital Association (AHA) Annual Survey and the 1994 Medicare Hospital Cost Report data sets. Market-level data came from the Area Resource File. STUDY DESIGN: Multiple regression analysis was used to examine the effects of hospital size, dependence on managed care, ownership, network, system and alliance memberships, and level of diffusion of community-orientation practices in the area on the degree of community orientation in hospitals. The model, based on Oliver's (1991) framework of organizational responsiveness to environmental pressures, controlled for the effects of industry concentration and lagged profitability. PRINCIPAL FINDINGS: Degree of community orientation is significantly related to hospital size; ownership; dependence on managed care; and membership in a network, system, or alliance. It is also significantly related to the diffusion of community-orientation practices among other area hospitals. CONCLUSIONS: Degree of community orientation is influenced by the nature of environmental pressures and by hospital interests. It is higher in hospitals that are large, nonprofit, or members of a network, system, or alliance; in hospitals that are more dependent on managed care; and in hospitals that operate in areas with higher diffusion of community-orientation activities.

American Hospital Association↗
PubMed2001

Asthma prevalence, cost, and adherence with expert guidelines on the utilization of health care services and costs in a state Medicaid population.

OBJECTIVE: To provide a descriptive analysis of asthma prevalence and costs in a Medicaid population and gauge the degree of adherence with expert guidelines for asthma medication management from the National Asthma Education and Prevention Program. DATA SOURCES: Kentucky Medicaid administrative data for 1996. STUDY DESIGN: A cross-sectional retrospective analysis was used to determine adherence with asthma medication guidelines and utilization of asthma-related health care services and costs. Multivariate logistic regression was used to determine the relationship between nonadherence with the guidelines and utilization of health care services. PRINCIPAL FINDINGS: Of the 530,000 Medicaid recipients, 24,365 (4.6 percent) were identified as having asthma. Average annual asthma-related costs ($616) accounted for less than 20 percent of total health care costs ($3,645). Nonadherence to the guidelines was prevalent. Less than 40 percent of the patients received a prescription for a rescue medication, and fewer than 10 percent of the patients who received daily inhaled short-acting beta-2 agonists were regular users of inhaled steroids. Nonadherence to the guidelines was associated with an increased risk of an asthma-related hospitalization (odds ratio = 1.5, p < .05). CONCLUSIONS: Guideline nonadherence was widespread and associated with an increase in exacerbations of asthma that resulted in hospitalizations. Asthma prevalence and utilization of health care services in a Medicaid population were similar to previous estimates reported nationally and in health maintenance organizations.

Adolescent↗
PubMedDate not supplied

Use of clinical indicators to evaluate COPC projects.

BACKGROUND: In 1989, Ramsey Family and Community Medicine Residency adopted a population-based focus for teaching and clinical activities based on the principles of community-oriented primary care (COPC). Evaluation and outcomes measurement proved problematic for each of the five COPC projects we implemented. METHODS: Surrogate measures, or key clinical indicators, were used to monitor the following COPC projects at Ramsey Family Physicians clinic: preschool immunization, family-centered birth, intimate interpersonal violence, teenage pregnancy-sexually transmitted disease prevention, and human immunodeficiency virus (HIV) screening. RESULTS: Between 1995 and 1998, we documented a decline in preschool immunization rates, an increase in preterm births and low-birth-weight infants, improved intimate interpersonal violence screening, a high but stable teenage pregnancy rate, a decrease in teenage chlamydia rate, and improved HIV prenatal screening. Our data collection and analysis were complicated by a lack of relevant indicators related to target goals, a shifting denominator, incomplete data and an unstable numerator, disconnected data sources, and missing comparison data. CONCLUSIONS: COPC project evaluation is an evolving process, and measurement deficiencies become recognized with time. Even so, outcomes measurement legitimizes COPC interventions and provides a value-added component to resident education and clinical activities.

Adolescent↗
PubMed1992

Physiology and pathophysiology of atrial natriuretic factor in lungs.

UNLABELLED: OBJECTIVE AND DATA SOURCE: Experimental and clinical data reported in the international literature have been collected and critically reviewed to summarize knowledge of the role of atrial natriuretic factor (ANF) in lung physiology and pathophysiology. DATA SYNTHESIS: Lung contribution to circulating ANF concentration is modest, whereas its capability of degrading ANF is very high, the lung being one of the major sites of ANF catabolism. The impairment of ANF protease activity in lung tissue by hypoxia and pulmonary hypertension could be responsible for the increase in ANF plasma levels observed in several pulmonary pathological conditions. ANF-specific binding sites in lung are reportedly greater than in any other tissue. ANF induces a cGMP-mediated relaxation of central (rather than peripheral) bronchi. ANF bronchodilating effect has also been clinically demonstrated; eg, asthmatic patients show increased plasma ANF levels and exogenous ANF infusion provokes bronchial relaxation comparable with the salbutamol-induced effect. Moreover, ANF determines pulmonary artery vasodilation, thus contributing to improved pulmonary circulation. When pathophysiological levels are present in plasma, ANF influences pulmonary fluid regulation provoking protein mobilization from arteries to the alveolar space whereas ANF pharmacological concentrations re-equilibrate the transwall gradient. A remarkable enhancement of guanylate cyclase activity in lung tissue before hemodynamic modifications by both endogenous end exogenous ANF has been reported in pneumocytes of cardiomyopathic hamsters. On the other hand, ANF infusion provokes a reduction of pulmonary edema induced by pneumotoxic chemicals through a mechanism independent of the natriuretic/hypotensive action of the peptide and not mediated by cGMP. CONCLUSIONS: The modest amount of specific research on ANF effects on lung does not permit a final assessment of natriuretic peptides in pulmonary physiology and pathophysiology. In particular, further investigations are needed to determine the potential clinical relevance of ANF in asthma and pulmonary edema.

Animals↗
PubMed2002

Small hepatocellular carcinoma: current status and prospects.

BACKGROUND: More than two decades have gone by since the early report of resection for small hepatocellular carcinoma (HCC), which resulted in improved prognosis of HCC. OBJECTIVE: To review the past and recent data, and prospect the future in this field. DATA SOURCES: Literature and recent data from the Liver Cancer Institute of Fudan University, Shanghai, China. DATA SYNTHESIS: 1232 patients with small HCC from the institute were analyzed between 1960-1984 (n=107) and 1985-1999 (n=1125). The increase of limited resection rate from 69.5% to 82.5% contributed in part to the increase of resectability from 76.6% to 95.5%, decrease of operative mortality from 2.4% to 1.2%, and improvement of 5-year survival after resection (from 53.1% to 64.0%). The 5-year survival was higher after limited resection than after lobectomy, being 64.4% versus 55.9%. The 5-year survival after resection was superior to that after cryosurgery and other regional cancer therapies (32.8%). However, molecular studies found that biological characteristics were only slightly better in small HCC than in large HCC. CONCLUSIONS: Resection remains the treatment choice for small HCC with compensated liver function, while regional cancer therapies and liver transplantation are alternatives for patients with incompensated liver function. Biological characteristics remain the leading factor influencing prognosis of small HCC.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

[Evaluation of the effects of occupational noxae on the cardiovascular system].

BACKGROUND: Working conditions and the environment may contribute to the multi-factorial aetiology of cardiovascular disease. OBJECTIVES: To provide a critical assessment of epidemiological and clinical methods and tools for evaluating the effects of occupational pathogenic noxae on the cardiovascular system. METHODS: A review was made of epidemiological and clinical studies published in the main scientific journals of occupational medicine and cardiology, in the period 1980-2003. Data sources were electronic medical data bases and conference proceedings. RESULTS AND CONCLUSION: Collecting case histories by means of free or questionnaire-structured interviews, observing specific physical signs, detecting changes in blood chemistry parameters and identifying morphological or functional abnormalities in the heart and vessels are all useful approaches. Some blood chemistry parameters that may be modified by occupational exposure or by particular conditions arising from work organization are cholesterol, triglycerides, apolipoproteins A and B, platelets, fibrinogen, factor VIIc, fibrinolysis products, plasminogen tissue activating factor, complement and glycated hemoglobin. They can all be measured easily and quickly and provide an estimate of the risk of cardiovascular disease. As high blood pressure is closely correlated to heart disease, blood pressure levels can be monitored in a working population using a standard mercury sphygmomanometer. Electronic measurement before and after a work shift and 24 hour Holter monitoring help reduce the "white coat effect" and provide further useful information. Occupational risk factors such as toxins (metals, solvents, pesticides), electromagnetic fields, extreme temperatures, noise, radiation and psychophysical stress can affect the cardiac neuro-autonomic balance of the exposed workers and cause cardiovascular abnormalities. These can be detected by long-term ECG monitoring, and are revealed as reduced heart rate variability and prolonged QT interval. Recently non-invasive systems have been adopted to detect cardiovascular lesions that are usually due to atherosclerosis. In occupational and environmental studies ultrasound measurement of intima-medial carotid thickness and brachial artery reactivity have been used to determine the effects of exposure to carbon disulfide and passive smoking. Occupational Medicine has yet to include the use of the very expensive electron-beam computed tomography for a rapid and non-invasive study of coronary artery disease.

Arrhythmias, Cardiac↗
PubMed2004

Brain tumor treatment: chemotherapy and other new developments.

OBJECTIVES: To provide a summary of chemotherapy used in the management of malignant brain tumors, including a historical perspective, current standard therapies, and promising new therapies. DATA SOURCES: Published articles, research data, and reference books. CONCLUSION: Chemotherapy is used to treat several types of brain tumors, including primary central nervous system lymphomas, medulloblastomas, brain metastases, and malignant gliomas. New therapies, including cytostatic agents and molecular therapies, are being evaluated and used in the management of brain tumors. IMPLICATIONS FOR NURSING PRACTICE: It is essential for the oncology nurse to possess knowledge of the different types of brain tumors treated with chemotherapy, current chemotherapy regimens, new innovative therapies, and nursing management issues specific to this population.

Anti-Inflammatory Agents↗
PubMed2004

[Condition of the children born after assisted reproduction in Czech Republic].

OBJECTIVE: A retrospective study of data, with an analysis of bio-social factors and the incidence of birth defects in the children born out of pregnancy resulting from assisted reproduction in the Czech Republic in the period from 1995 to 2002. Also, the objective was to analyse these factors in comparison with a group of children born during the same period after spontaneous conception. DATA SOURCE AND METHODS: The data were obtained from the National Health Registers, the administration of which has been entrusted to the Institute of Health Information and Statistics of the Czech Republic (IHIS CR). Specifically, the National Register of Birth Defects and the National Register of Neonates were used. Groups of children born after spontaneous conception and after assisted reproduction were analysed. We analysed the frequency of pregnancy, the gestation week at birth and birth weight, the incidence of immaturity at birth, hypotrophy, hypertrophy, the incidence of birth defects in prenatally and postnatally diagnosed cases and the mortality rate during the 1st year of life. RESULTS: In the period 1995-2002, a total of 731,617 children were born in the Czech Republic. During the same period, a total of 14,243 children were born after assisted reproduction. A statistically significant higher (p<0.0001) proportion of the children born out of multiple pregnancies (40% in the assisted reproduction group as compared with 1.7% in the spontaneous conception group) was identified. The overall mortality rates (early neonatal mortality and infant mortality) are significantly influenced by the number of children within a pregnancy, and as a consequence of the unfavourable distribution in the assisted reproduction group (statistically significant higher representation of children from multiple pregnancies), the rates are higher in the assisted reproduction group. CONCLUSION: The frequencies of children born with a birth defect in the assisted reproduction group and in the group of other born children were not statistically significant. The differences in mortality rates, birth weights and the gestation week are caused by the unfavourable demographic distribution in the assisted reproduction group.

Birth Weight↗
PubMed2004

[Survival of children born with selected types of birth defects in Czech Republic].

OBJECTIVE: A retrospective study of data with an analysis of the prenatal and postnatal incidence of selected types of birth defects in the Czech Republic during the period from 1994 to 2003. The objective was also to analyse the percentage of deceased children born with selected types of congenital defects from the total number of deceased children. DATA SOURCE AND METHODS: The data on prenatal diagnostics were obtained from particular department of medical genetics in the Czech Republic. The data on the incidences of birth defects in the born children were obtained from the data of the National Health Registers, the administration of which has been entrusted to the Institute of Health Information and Statistics of the Czech Republic (IHIS CR). Specifically, the data from the National Register of Congenital Defects and the National Register of Neonates were used. The analysis of the frequencies of prenatally and postnatally diagnosed cases of twelve selected types of birth defects was carried out for the Czech Republic for the period from 1994 to 2003. For the cases of postnatally diagnosed defects, an analysis of survival and mortality of the affected individuals during the 1st year of life was carried out for selected types of birth defects. RESULTS: In the period 1994-2003, a total of 932,153 children were born in the Czech Republic. Including the cases of successful prenatal diagnostics, we analysed 268 cases of anencephalia, 384 cases of spina bifida and 80 cases of encephalocele, 425 cases of congenital hydrocephalus, 261 cases of omphalocele and 258 cases of gastroschisis, 225 cases of congenital defects of oesophagus and 279 anorectal malformations; 232 cases of diaphragmatic hernia, 411 cases of agenesis/hypoplasia of kidneys and 438 cystic kidneys; and 1,412 cases of Down's Syndrome. The success rate of secondary prevention was high for the defects of neural tube (55-96%), for the defects of abdominal wall (55-78%) and for the Down's Syndrome (59%). As concerns the defects treatable by surgery, the survival rate in the first year of life of the born children was lowest in the case of congenital hydrocephalus (63%) and in the case of neural tube defects (75-84%). However, in the case of GIT congenital defects (the defects of abdominal wall, diaphragmatic hernia, congenital defects of oesophagus and anorectal malformations), 82 to 91% of the born children survived. CONCLUSION: Immaturity and concurrent incidence of additional birth defects prolong the period of hospitalisation, UPV and total parenteral nutrition in the case of the affected neonates. This deteriorates the prognosis of the children born with birth defects. Possible reduction of the incidence of these cases could be achieved through improvement in prenatal diagnostics, specifically through more timely identification of mainly the serious types of defects with the presence of associated congenital defects. Another possibility to improve the survival rate of children is the development of surgical procedures and specialised neonatal and infant intensive care.

Congenital Abnormalities↗
PubMed2005

Assessing the financial effect of Medicare payment on rural hospitals: does the source of data change the results?

In this policy brief, we explore how predictions of changes in hospital financial performance as a result of change in Medicare payment differ when comparing results using data from the Medicare Cost Report (MCR) to results using data from the audited hospital financial statement (FS). The purpose of this exploratory research is to test the assumption that MCR data yield a valid indicator of changes in hospital financial well-being.

Data Collection↗