|
Index - Major Sections
Home
**InHCc HMIS**
Site Map
Health Economic and Reform
Benefits
Discussion
Data and Data Analysis
Health Management
Product and Services
References
Team
_______________
Index - Same Level Subject
Index - Child Subjects
| |
Introduction
The following are only some of the reports that can be produced
from the data that has been collected from clients. In many cases, along with surveillance
sites, the information can be used for estimates of National Health.
Standardization Of
Reported Information
Raw Data
-
Number
of patients seen in outpatient
-
Common
complaints of these patients
-
Abnormal
Physical Examinations
-
Length
spend in Triage (Better overall
care may be given be having Triage spend more time taking the symptoms and
history)
-
Time
spent in out-patient clinic
-
Patients
examined by Nurse or Physician
-
Treatments
ordered and given by date and time
-
Physician
or Nurses who cared for these patients
-
Supplies
used in the treatment of patient
-
Services
provided:
-
x-rays
-
lab
tests
-
meals
given
-
Nursing
services provided
-
Physician
services provided
-
Lab
Results Obtained
-
Number
of patients admitted
-
Time
spent in in-patient clinic
-
Final
Diagnosis of illnesses
-
Patient’s
condition and any follow up at discharged
Accounting and Management Control
- Length
of time waited to be seen by physician: May not be enough physicians per
patient, incorrect scheduling of time physicians are in service.
- Length
of time between patient arrival and beginning of treatments
- Fees
collected: Does the amounts collected match with patients treated?
- Costing
by patient: Are the standards as established accurate?
Medical Standards
Medical
Audit Committee: Audits retrospectively the clinical application of medical
knowledge and compares care rendered to the pre-set standards (De Geyndt 1995).
The strategy developed by Williamson (1971) focuses on diagnostic categories or
specific clinical procedures. Standards are set consensually by physicians for
physicians.
-
Number
of Revisits for same illness: Patient may have been discharged too soon;
treatment was not appropriate, living conditions unsuitable, etc.
-
Standards
met for fluid requirements: Are the ped’s receiving the correct amount of
fluids for their diagnosis and physical?
-
Comparisons
between “complaints” and “preliminary diagnosis”: Does the diagnosis
match up with the patients’ complaints?
-
Comparisons
between “preliminary diagnosis” and “standard treatments” given:
Were the correct treatments given to the patients or where the treatments
too costly for the diagnosis.
-
Comparisons
between “preliminary
diagnosis” and “final diagnosis”: Was the correct medical history and
examination performed?
-
Comparisons
between “expected number of
days of care” and “actual” days of care: Did the patient stay longer
in the unit then was normal for the diagnosis?
-
Patient
“outcome:” Does the actual patient outcome match what was expected based
on the treatment given adjustment for severity of illness on admission
-
Number
of patients not weighed: Does this improved examination taking?
-
Number
of incomplete physicals given: Does this improved history taking?
Social Concerns
Access to service
-
Number of patients who had to
travel farther than xxx to receive service.
-
Means of transportation appropriate
for illness
-
Fee charges commensurable with
income level
Outcomes
Patient outcomes will be measured by analysis data from the
Medical Audit Committee.
Outcomes will be divided into three types of outcomes:
-
Diagnostic
outcomes
-
Therapeutic
outcomes
-
Discharge
condition
The
diagnostic outcomes and the therapeutic outcomes will be measures again
standards.
The
discharge outcome will be measured also again standards. These standards will be
that of
Resource Utilization
Utilization
Review Committee: decides whether the clinic’s facilities are used
appropriately in the provision of care. It reviews, for example, appropriateness
of admissions and discharges, proper use of outpatient and emergency services,
and the optimum utilization of diagnostic and therapeutic support services (De
Geyndt 1995):
-
Physician/nurse
time spent with patient/ number of patients seen per physician:
-
Tracking
of the time spent by physicians and nurses in patient care. Was it too
little or too much based on the diagnosis? Do higher staff ratios per
patient lead to lower morbidity/mortality?
-
Time
spent by Nursing “teaching.”
-
Number
of physicians, nurses as a % of the number of patients seen: It there a
proper ratio of physicians and nurses for the patients
-
Utilization
Rates of facilities: Where the facilities overused leading to poor sanitary
and hospital? Does higher occupancy rates lead to higher
morbidity/mortality?
-
Length
of time for lab result return: Were the lab results returned in a timely
manner?
-
Drug,
Pharmacy or therapeutic committee: formulates and recommends policies and
priorities which will ensure that the best use is made of available drugs
and therapeutic agents in terms of optimal utilization and minimal potential
for harm to the patient (De Geyndt 1995):
-
Drug
available as a % of patient volume: Is there sufficient amount of drugs on
hand? Are there too much and too many drugs in inventory leading to
out-dated supplies?
-
Drugs
available as a % of daily usage = # of days on hand: Are there sufficient
amount of drugs on hand? Are there too much and too many drugs in inventory
leading to out-dated supplies?
-
Tracking
of drugs used by patient: Was the correct drug given for the diagnosis? Does
higher drug use per episode lead to improved length of stay?
-
Comparison
of drugs given with the results of the lab reports.
-
Tracking
of important supplies used by patient: Are all the supplies in inventory per
count?
Human
Resources
National Implications
Global
Monitoring:
-
Abnormal
number of “certain types” of complaints
-
Abnormal
number of + lab results for a particular diseases: Implication = “outbreak
of a disease”
-
Communicable
diseases reported
-
National
inventory control of drugs
-
Reports
of vital statistics
-
Births
-
Deaths
-
Vaccinations
-
Malnourished
children
Intangible Benefits
-
The
use of detail records to analyze the organization will discourage employees
from “making up” the data.
-
Provides
incentives for the staff to improve technical and outreach skills and
increase motivation. If there is no one watching, no feedback, and no
indicators for them to value their services then there is no reason to
improve.
-
Target
groups to receive care based on the results of the demographic data can be
determined
-
Expert
systems may provide improve diagnosis and learning experiences.
Economic and Social Predictors and Risk Factors
Economic Security
- Percent of client using system at or below the poverty
level (rates to be determine at both local and national levels) [Economic]
- Rate of increase in real wealth of clients determined by
number of household items owned. [Economic]
- Maternal Employment. Percentage of Mothers with children
under age 18 who are employed, full-time and part-time
Work Status
- Clients Work Status by occupation, wage rates, duration,
- Percent of households without an individuals as a full
time wage earner.
- Percent of Working Women
- Percent of Clients working in "Low skill" jobs
Education
- Number of Clients by Age and Education Level Attainment
[Education]
- Percent of Children enrolled in school, by age, level,
length of time in school
- Reading levels of Clients by age,....
Social
- Ethic distribution
- Average Age of marriage of women/men
- Births by Age of mother, by ethic group, economic status,
education
- Average Age of woman for birth of first child
- Average Number of Children at each age level of the
mother
- Reported Child Abuse and neglect
- Distribution of Families by number of children
- Suicide
Health Predictors
Identity of clients at risk by categories of risk type
Birth
- Low and Very Low Birth Weights
- Birth weight
- Apgar
- Preterm Birth
- Number of Prenatal Care Visits distribution by mother's
age, education, economic status, mother's risk factors such as use of
alcohol, tobacco, drugs.
Health Conditions
- Percent of Children in Very good or excellent health
- Percent of Children ages 19 months to 35 months who are
fully immunized
Mortality
- Infant Mortality by Age of Mother, Ethic Group, Economic
Static, Education...
- Child and Youth deaths be age, gender, cause, ethic
group, economic static...
Chronic Health Conditions for Children
- Respiratory Conditions
- Chronic Bronchitis
- Chronic Sinusitis
- Asthma
- Chronic Diseases of tonsils or Adenoids
-
Impairments
-
Other
Conditions
Health Risks
- Food Security. Clients concern with being able to afford
food [Medical Client health, Nutrition]
- Access to Health Care
- Percent of Client who report alcohol, tobacco, and drug
use
Population, Family, and Neighborhood
Child Population Characteristics
- Number of Children Under age 18
- Children as a percentage of the total Population
- Fertility Rates
- Number Of Births
Family Structure
- Percentage of Families with Children and Distribution of
Families by Number of Children
- Percent of Households by Type
- Residential Stability. Percentage of Children under who have moved within the last year
by age
- Divorce Rate
- Percent of Children with Both Parents or Only Resident
Parent in the Labor Force
- Maternal Employment: Percentage of Mothers with children
under 18 who are employed, full-time and part-time by Age of Child,
Marital Status, Ethnic group
Family Planning
Dimensions
- Women's Age
- Number of Lining children
- Education
- Economic Status
- Time
Report Results
As well as the routine reports the following data may also
be collected
- Percent of High Risk clients serviced
- Amount of substitution in clients serviced
- Continuation Rates
- Complication rates
Examples
Data Collection
-
Fertility Preferences
-
Education level
-
Economic Status
- Mortality Rate
- Number of children already in family
- Age of woman
- Demand for children
- Level of infant mortality
- Social Trend (longitudinal time trend)
External
reporting (Donors)
-
Number
and type of services offered
-
Number
of visits by type of service
-
Value
of Indicators used by project management
-
Resource
Utilization
-
Population
size by geographical area and time
-
Age
distribution by geographical area and time
-
Sex
distribution by geographical area and time
-
Marital
status and number of wives, if appropriate, by geographical area and time
-
Number
of children and age distribution by geographical area by time
-
Fertility
rate by geographical area and time
-
Child
mortality rate by geographical area time
-
Contraceptive
prevalence by geographical area and time
-
Average
number of family members in household by geographical area and time
-
Education
level by geographical area and time
-
Number
of units distributive by product by geographical area and time (such as
telephones, TVs, automobiles, electrical power used.)
Research - Advance Analysis
Using
“Database Warehouses and Data Mining techniques” all data is made available
for advance analysis using standard libraries of statistical, optimization, and
forecasting modeling functions. .
Misc to be categorized.
-
Distribution
of clients, by #of visits, by request type
-
Risk factors for
each patient as determined by the service provider at the beginning of the
project vs risk factors over time.
|