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Public Health and Population Health: Leveraging Electronic Health Record Data for Local Population Health Surveillance
Başlık:
Public Health and Population Health: Leveraging Electronic Health Record Data for Local Population Health Surveillance
Yazar:
McCormick, Emily V., author.
ISBN:
9780438003040
Yazar Ek Girişi:
Fiziksel Tanımlama:
1 electronic resource (196 pages)
Genel Not:
Source: Dissertation Abstracts International, Volume: 79-10(E), Section: B.
Advisors: Heather Haugen; Arthur Davidson Committee members: Catherine Battaglia; John Douglas; Michael Kahn.
Özet:
Background: While measurement is a population health priority, traditional data sources provide limited local health insights. Local public health agencies (LPHAs) are evaluating the feasibility of using electronic health record (EHR) data, which could provide more detailed health data in a timelier manner, but must be further explored and validated for surveillance uses.
Purpose: A mixed methods study was conducted to assess LPHAs' capacity for EHR-based surveillance, conduct a comparison of EHR-based estimates, and explore more granular, EHR-based, population health insights.
Methods: Twenty five LPHA interviews were conducted to understand EHR-based surveillance practices and attitudes. Quantitative methods were then used to validate EHR-based chronic disease prevalence estimates (i.e., diabetes and hypertension) through comparison with survey-based estimates, apply population weights to generate adjusted prevalence estimates, and pilot county and census tract estimation of chronic disease control. EHR data from three healthcare providers for Denver adults (2011--2015) were extracted, geocoded, transformed and analyzed at the county and census tract level.
Results: LPHAs believe EHRs hold meaningful local health data, but less than 20% are using EHR-based surveillance. EHR data suggested that adult diabetes prevalence significantly increased from 10% in 2011 to 11% in 2015 (p ≤ 0.0001) and was higher than survey's estimate (7% in 2015). EHR-based hypertension prevalence estimates declined from 20% in 2011 to 19% in 2015 (p ≤ 0.0001) and were below survey based estimates (27% in 2015). Census tract hypertension prevalence estimates spanned 4.3% to 41.7%. EHR-based diabetes control decreased from 80% in 2011 to 78% in 2015 (p ≤ 0.0001) and hypertension control decreased from 74% in 2011 to 71% in 2015 (p<0.0001).
Conclusions: LPHAs face many challenges in EHR-based surveillance and need staff with advanced skills to utilize EHR data to measure new and existing indicators at a granular geographic level. EHR-based prevalence estimates were close to population surveys but are not statistically equivalent. EHR-based prevalence and control estimates were sensitive to year over year changes and socio-demographic disparities and produced novel census tract-level information.
Notlar:
School code: 1639
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Yer Numarası | Demirbaş Numarası | Shelf Location | Lokasyon / Statüsü / İade Tarihi |
---|---|---|---|
XX(680454.1) | 680454-1001 | Proquest E-Tez Koleksiyonu | Arıyor... |
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