Study objectives: Emergency medical services (EMS) is an important part of the health care system. The effect of EMS on morbidity, mortality, and costs of illness is difficult to evaluate because hospital information ...
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Study objectives: Emergency medical services (EMS) is an important part of the health care system. The effect of EMS on morbidity, mortality, and costs of illness is difficult to evaluate because hospital information is not available in out-of-hospital databases. We used probabilistic linkage to create such a database from ambulance and inpatient data and demonstrate the potential for linkage to facilitate evaluation of EMS responses resulting in hospital admission. Methods: Statewide ambulance and inpatient hospital discharge records were available for 1994 through 1946. Ambulance records indicating admission to the emergency department or hospital (165,649 records) were linked to inpatient hospital records indicating emergency admission (146,292 records) by using probabilistic linkage. Out-of-hospital data (dispatch code, treatments rendered, and ages), linkage rates, and inpatient data (discharge status, charges, length of stay, and payer category) were analyzed. Results: We linked 24,299 (14.7%) ambulance events to inpatient hospital discharges. If we had used exact linkage methods, we would have only linked 14,621 record pairs, a loss of nearly 40%. linkage rates were relatively constant between years (approximately 15%) but differed by ambulance dispatch codes. Out-of-hospital dispatch codes with high linkage rates included breathing problems (22.6%), chest pain (21.5%), diabetic problems (16.9%), drowning incidents (14.9%), falls (19.2%), strokes (32.8%), and unconsciousness or fainting episodes (16.1%). Linkage to the hospital record provided access to hospital outcome data. Inpatient mortality was 6.8%. Survivors were discharged home (60.7%), transferred to other acute-care facilities (3.6%) or intermediate-care facilities (23.3%), or discharged with home health care provision (4.9%). The median length of stay was 3 days, and median charges were $6,620;total inpatient charges were $286,737,067. Conclusion: Probabilistic linkage enables ambulance and hospita
A framework for designing an information system for planning and monitoring of rural health services is proposed in the Indian context. For effective monitoring the framework emphasises selection of a set of programme...
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A framework for designing an information system for planning and monitoring of rural health services is proposed in the Indian context. For effective monitoring the framework emphasises selection of a set of programmed and non-programme indicators on inputs, activities, efficiency and impact and their integration at the district level. For planning, a village level data base is proposed which will integrate environmental data with health programme data. Illustrative examples are provided for key features of the MIS and finally those elements of the information system which are either too complex or too voluminous to be handled manually are identified and the possibility of using computers for such analysis is explored.
Despite its benefits, the computerisation of Australian general medical practices has been delayed, partly due to user concerns about the format of data dictated by available software and the portability of such data....
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Despite its benefits, the computerisation of Australian general medical practices has been delayed, partly due to user concerns about the format of data dictated by available software and the portability of such data. This article proposes certain essential criteria for practice management software, which may provide a framework for its evaluation by users. A set of simple guidelines for database maintenance is also proposed. The author believes that users should become familiar with basic software architecture and drive the market to develop packages that conform to these minimal criteria.
This study considers the problem of inferring a functional evaluation criterion from existing performance measure policies. The objective is to develop a rational basis by which to adaptively evaluate a current best s...
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