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Studying Health and Health Care

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Best overall indicator of health status incorporating need for health care ... use of preventive or screening programs, despite universal free health care in Canada. ... – PowerPoint PPT presentation

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Title: Studying Health and Health Care


1
Studying Health and Health Care
MANITOBA CENTRE FOR HEALTH POLICY
  • Leslie L. Roos, Noralou P. Roos
  • Charlyn D. Black, Ruth-Ann Soodeen, Eileen Pyke

2
POPULATION HEALTH HEALTH POLICY Using a
Population Health Framework to Improve the
Delivery of Health Care
3
POPULIS A Tool for Population-Based Analyses
Physicians
Utilization
Regional population - SES - Health
H
Utilization
Hospitals
H
Utilization
PCH
Personal Care Homes
PCH
PCH
4
Organizing Principles of POPULIS
  • 1. It describes
  • - supply
  • - access to care
  • - intensity of use
  • - differential use across areas
  • 2. It juxtaposes indicators of -
    socioeconomic risk
  • - use
  • - health

5
  • 3. It assesses contributions to costs per capita
    of
  • - differential access
  • - dollars per service (visit, day of care)
  • 4. It is relevant to system managers
  • 5. It sums use across sectors
  • 6. It creates regional profiles

6
Figure 1. An Ideal Administrative Data Base
Medical
Hospital
PersonalCare Home
Home Care under development
Population - Based Research Registry
Provider
Pharmaceuticals
Vital Statistics
Cost
7
Where to find Population-Based Administration Data
  • 1. Several Canadian provinces
  • 2. Rochester (Minnesota) Epidemiology Project
  • 3. Oxford Record Linkage Study
  • 4. Scottish Record Linkage System
  • 5. Western Australia Health Services Research
    Linked Database Project

8
Organizing and Accessing Information
  • Since many researchers use the same
  • data to answer different research
  • questions, various methods of analysis
  • may be applied to them.
  • Problem How can an organization store
  • its working knowledge for easy access
  • and to guard against conflicting
  • interpretations of the same data?

9
Other On-line Dictionaries
  • Glossary - gateway to Concept Dictionary
  • Data Dictionaries - list and describe variables
    and file structure for databases.

10
Commonly Used Health Measures
11
  • Indicator Selection
  • The indicators included have been selected
    because of their potential value for health care
    system management
  • Hospital indicators - distinguish between types
    of admissions, and use that occurs in-region vs.
    out-of-region.
  • Physician Supply Indicators - distinguish
    between physicians available to area residents
    because they live in the area, and those
    available because residents travel (as do
    physicians sometimes).

12
Developing Indicators Steps
  • 1. Create meaningful geographical areas
  • 2. Obtain denominator data for each area
  • 3. Develop indicators of socioeconomic risk for
    each area
  • 4. Develop indicators of health status
  • 5. Describe utilization of health care by
    residents

13
Community Indicators
  • 1. Demographic profile
  • 2. Low weight births
  • 3. Health care system sensitive
    indicators

14
  • 4. Mortality indicators population
    cause-specific
  • 5. Indicators based on rates of individuals
    hospitalized
  • 6. Indicators based on rates of physician contact

15
FLAGSHIP INDICATOR
  • Premature Mortality Rate
  • (Rate of death of persons 0-74)
  • ? Best overall indicator of health status
    incorporating need for health care
  • ? Well correlated with morbidity measures

16
Questions Recently Addressed Using POPULIS
  • 1. Have bed closures adversely affected
  • A. Manitobans access to care?
  • B. The quality of care delivered?
  • C. The health of the population?

17
Number of Procedures
18
Deaths per 100 Cases
19
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20
  • 2. When does seasonal hospital overcrowding
    occur? Why does it occur? Is it due to bed
    shortages?

21
AVG. DAILY NUMBER OF INPATIENTS
High Pressure Level
Normal Range
Apr May June July Aug Sep Oct
Nov Dec Jan Feb Mar
22
AVG. DAILY NUMBER OF INPATIENTS
High Pressure Level
Normal Range
Flood
Apr May June July Aug Sep Oct
Nov Dec Jan Feb Mar
23
3. How long are Manitobans waiting for surgery?
Have waiting times changed? Do certain groups get
surgery faster?
24
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25
1992 93 94 95 96 1992 93
94 95 96 1992 93 94 95 96
26
4. Are there different ways of delivering
preventive or screening programs that are
successful in reaching all groups in the
population?
27
Research has shown that poor people tend to
have more health problems than the wealthy and
that they are less likely to make use of
preventive or screening programs, despite
universal free health care in Canada. Roos,
Traverse and Turner (1999)12 considered how such
services could successfully reach all groups in
the population. They used data from the research
registry and from files maintained by two
established provincial programs to examine
childhood immunization, screening mammography and
cervical cancer screening.
28
I
P
M
m
I m M P
29
Conclusions
  • As we rethink health in the context of a
  • population health framework, there is a need for
  • an information system designed to provide
  • evidence to support policy and health services
  • decisions in managing the health care system.
  • There is an equal need to communicate research
  • findings with policymakers, providers, and the
  • public.
  • - Hon. Darren Praznik, Former Minister of
    Health, Province of Manitoba13
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