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41.
Background
The “meaningful use of certified electronic health record” policy requires eligible professionals to record smoking status for more than 50% of all individuals aged 13 years or older in 2011 to 2012.Objectives
To explore whether the coding to document smoking behavior has increased over time and to assess the accuracy of smoking-related diagnosis and procedure codes in identifying previous and current smokers.Methods
We conducted an observational study with 5,423,880 enrollees from the year 2009 to 2014 in the Truven Health Analytics database. Temporal trends of smoking coding, sensitivity, specificity, positive predictive value, and negative predictive value were measured.Results
The rate of coding of smoking behavior improved significantly by the end of the study period. The proportion of patients in the claims data recorded as current smokers increased 2.3-fold and the proportion of patients recorded as previous smokers increased 4-fold during the 6-year period. The sensitivity of each International Classification of Diseases, Ninth Revision, Clinical Modification code was generally less than 10%. The diagnosis code of tobacco use disorder (305.1X) was the most sensitive code (9.3%) for identifying smokers. The specificities of these codes and the Current Procedural Terminology codes were all more than 98%.Conclusions
A large improvement in the coding of current and previous smoking behavior has occurred since the inception of the meaningful use policy. Nevertheless, the use of diagnosis and procedure codes to identify smoking behavior in administrative data is still unreliable. This suggests that quality improvements toward medical coding on smoking behavior are needed to enhance the capability of claims data for smoking-related outcomes research. 相似文献42.
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We investigate whether socioeconomic status, measured by income and education, affects waiting time when controls for severity and hospital‐specific conditions are included. We also examine which aspects of the hospital supply (attachment to local hospital, traveling time, or choice of hospital) matter most for unequal treatment of different socioeconomic groups. The study uses administrative data from all elective inpatient and outpatient stays in somatic hospitals in Norway. The main results are that we find very little indication of discrimination with regard to income and education when both severity and aspects of hospital supply are controlled for. This result holds for both men and women. Copyright © 2013 John Wiley & Sons, Ltd. 相似文献
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岳伟 《中国医疗器械杂志》2014,(5):357-360
该文从学习解读新版《医疗器械监督管理条例》出发,梳理了《条例》中体现的行政改革思路．提出了“十大原则”的思路,即全程监管的原则：分级监管的原则：风险分类的原则：安全有效节约原则;鼓励创新的原则：简化许可的原则：科学规范的原则：诚信自律的原则;监管明责的原则：违法严处的原则。并就此进行了讨论。 相似文献
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目的探讨军队离休老干部患者的常见心理问题,制定并实施相应的护理措施。方法收集2011年1月至2013年1月期间,我科住院治疗的离休老干部200例,调查分析其心理特点,制定并实施合理有效的护理方案。结果患者的护理满意度达96.0%,护理后症状自评量表（SCL-90）各项因子评分均显著降低。结论离休老干部患者多存在不同程度的心理问题,护理人员客观准确地评估患者的心理状况,合理实施有效的心理护理措施,能够确保其身心健康,改善其生活质量。 相似文献
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医患之间关系分民事法律关系和行政法律关系。民事法律关系分为非典型合同关系和承揽合同关系,行政法律关系分为行政给付关系和行政强制关系。在基本医疗被定性为公共产品后,行政给付关系成为医患关系的重要组成部分。按照行政法的一般原理,当医疗机构与患者之间是行政法律关系时,因医疗行为引发的不利后果理应因由国家承担。 相似文献