Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2015
Automated Detection of Postoperative Surgical Site Infections Using Supervised Methods with Electronic Health Record Data.
The National Surgical Quality Improvement Project (NSQIP) is widely recognized as "the best in the nation" surgical quality improvement resource in the United States. In particular, it rigorously defines postoperative morbidity outcomes, including surgical adverse events occurring within 30 days of surgery. ⋯ As a prototype system, we combined local EHR data with the NSQIP gold standard outcomes and developed machine learned models to retrospectively detect Surgical Site Infections (SSI), a particular family of adverse events that NSQIP extracts. The built models have high specificity (from 0.788 to 0.988) as well as very high negative predictive values (>0.98), reliably eliminating the vast majority of patients without SSI, thereby significantly reducing the NSQIP extractors' burden.
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Stud Health Technol Inform · Jan 2015
What are the Costs of Improving Access to Specialists through eConsultation? The Champlain BASE Experience.
Excessive wait times and poor access to care are among the most significant problems facing health care service delivery in Canada and beyond. We implemented the Champlain BASE eConsult service in the region of Ottawa, Canada to increase access to specialist care. We have collected ongoing utilization data and provider surveys over a three year period, providing a unique opportunity to explore the economic aspects of this multispecialty eConsult service. ⋯ This is one of the first studies to examine costs across a multispecialty eConsult service. We saw a marked decrease in the cost per eConsult over each annual period. Future research is needed to identify and examine similar outcomes that may lead to cost savings.
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The last six years the global community is facing an economic crisis that first appeared in USA. This crisis has a lot of impacts especially in health sector. Unemployment, job insecurity and the loss of disposable income have a significant impact in health too. ⋯ To collect the data it has been used the Greek version of Short Form (36) Health Survey (SF-36v2). In general, income, level of education, cohabitation and parenthood had a significant impact in quality of life. As a conclusion, unemployed participants' score was lower in the entire dimensions and in the two summary scales too.
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Stud Health Technol Inform · Jan 2015
Multicenter StudyThe Role of Hospital Information Systems in Universal Health Coverage Monitoring in Rwanda.
In this retrospective study, the authors monitored the patient health coverage in 6 Rwandan hospitals in the period between 2011 and 2014. Among the 6 hospitals, 2 are third level hospitals, 2 district hospitals and 2 private hospitals. Patient insurance and financial data were extracted and analyzed from OpenClinic GA, an open source hospital information system (HIS) used in those 6 hospitals. ⋯ The amounts paid by the patients for health services decreased in private hospitals to 25% of the total costs in 2014 (-7.4%) and vary between 14% and 19% in public hospitals. Although the number of insured patients has increased and the patient share decreased over the four years of study, the patients' out-of-pocket payments increased especially for in-patients. This study emphasizes the value of integrated hospital information systems for this kind of health economics research in developing countries.
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Stud Health Technol Inform · Jan 2015
The Prognostic Scale CRASH in the Treatment of Children with Severe Traumatic Brain Injury.
The aim of the present study was to assess the effectiveness and validity of prognostic scale CRASH which is calculated using on-line resources and which may serve as a decision support for physicians in treating severe traumatic brain injury (TBI) in children. This retrospective study was conducted using clinical and physiological data of 168 hospitalized pediatric patients with severe traumatic brain injury (GCS score less than or equal to 8). CRASH scale was used for calculating the severity of patients' state and for prognosing death outcomes at 14 days and at 6 months using the on-line resource. ⋯ The study has also shown that the scale has a satisfactory calibration ability in the option of 14 days with CT (χ2 equal 8.7 and p-value equal to 0.368). Calibration ability for other options was unsatisfactory. Thus, CRASH scale with CT scan has turned to be useful for assessing death outcomes at 14 days in children with severe TBI.