Working more productively: tools for administrative data

OBJECTIVE: This paper describes a web-based resource (http://www.umanitoba.ca/centres/mchp/concept/) that contains a series of tools for working with administrative data. This work in knowledge management represents an effort to document, find, and transfer concepts and techniques, both within the local research group and to a more broadly defined user community. Concepts and associated computer programs are made as "modular" as possible to facilitate easy transfer from one project to another. STUDY SETTING/DATA SOURCES: Tools to work with a registry, longitudinal administrative data, and special files (survey and clinical) from the Province of Manitoba, Canada in the 1990-2003 period. DATA COLLECTION: Literature review and analyses of web site utilization were used to generate the findings. PRINCIPAL FINDINGS: The Internet-based Concept Dictionary and SAS macros developed in Manitoba are being used in a growing number of research centers. Nearly 32,000 hits from more than 10,200 hosts in a recent month demonstrate broad interest in the Concept Dictionary. CONCLUSIONS: The tools, taken together, make up a knowledge repository and research production system that aid local work and have great potential internationally. Modular software provides considerable efficiency. The merging of documentation and researcher-to-researcher dissemination keeps costs manageable.     

New methods and data sources for measuring economic consequences of workplace injuries

BACKGROUND: Evaluation of programs and policies to reduce the incidence of workplace injuries require that the consequences of injury are estimated correctly. Because workplace injuries are complex events, the availability of data that reflects this complexity is the largest obstacle to this estimation. METHODS: We review the literature on the consequences of workplace injuries for both workers and employers, focusing on data sources, particularly linked administrative data from different public agencies. We also review other approaches to obtaining data to examine workplace injuries, including public-use longitudinal survey data, primary data collection, and linked employee-employer databases. We make suggestions for future research. RESULTS: Recent advances in the literature on the economic consequences of workplace injuries for workers have been driven to a great extent by the availability of new data sources. Much remains unexplored. We find longitudinal survey databases including the National Longitudinal Survey of Youth, and the Health and Retirement Survey, to be very promising though largely untapped sources of data on workplace injuries. We also find that linked employee-employer databases are well suited for the study of consequences for employers. CONCLUSIONS: We expect that new data sources should lead to rapid advances in our understanding of the economic consequences of workplace injuries for both workers and employers.     

Waste in the U.S. Health Care System: A Conceptual Framework

Context: Health care costs in the United States are much higher than those in industrial countries with similar or better health system performance. Wasteful spending has many undesirable consequences that could be alleviated through waste reduction. This article proposes a conceptual framework to guide researchers and policymakers in evaluating waste, implementing waste‐reduction strategies, and reducing the burden of unnecessary health care spending. Methods: This article divides health care waste into administrative, operational, and clinical waste and provides an overview of each. It explains how researchers have used both high‐level and sector‐ or procedure‐specific comparisons to quantify such waste, and it discusses examples and challenges in both waste measurement and waste reduction. Findings: Waste is caused by factors such as health insurance and medical uncertainties that encourage the production of inefficient and low‐value services. Various efforts to reduce such waste have encountered challenges, such as the high costs of initial investment, unintended administrative complexities, and trade‐offs among patients', payers', and providers' interests. While categorizing waste may help identify and measure general types and sources of waste, successful reduction strategies must integrate the administrative, operational, and clinical components of care, and proceed by identifying goals, changing systemic incentives, and making specific process improvements. Conclusions: Classifying, identifying, and measuring waste elucidate its causes, clarify systemic goals, and specify potential health care reforms that—by improving the market for health insurance and health care—will generate incentives for better efficiency and thus ultimately decrease waste in the U.S. health care system.     

军队离休干部112例住院死亡分析

目的了解军队离休干部的主要疾病死亡原因，评估各类死因的危害程度，为制定疾病预防与控制策略提供依据。方法对我院所属的军队师以上离休干部1993年1月-2004年12月112例死因资料进行归类、统计。结果军队师以上离休干部前4位死因构成顺位依次为恶性肿瘤（47．3％）、心血管疾病（27．1％）、呼吸系统疾病（14．1％）和脑血管疾病（7．1％），占全部死亡数的92．8％。恶性肿瘤死亡首位为肺癌，其次为胃癌和肝癌，三者共占64．1％。结论应加强老年人的肿瘤一级预防和二级预防，控制吸烟，控制高血压、高血脂及糖尿病，以降低军队离休干部的病死率。     

医政执法中医疗文书调查取证初探

医疗文书是医政执法中最典型、最有价值的文书类证据,是进行有效监管处罚的一项重要证据。本文阐释了医疗文书含义,分析其性质,并对其作为医政执法证据的取证要点进行分析,有助于提高获取医疗文书及固定证据效力的能力,推动医政执法工作更规范有序地开展。     

航空工业系统领导干部患者高血压病现状调查

目的 为了探讨航空工业系统领导干部高血压病患病率和分布状况，为预防工作提供科学依据。方法 对在１９９７年～１９９８年在航空工业总公司青岛疗养院举办的航空工业领导干部体检疗养斑全体干部进行了健康普查，高血压诊断标准采用世界卫生组织的标准进行。结果 高血压总患病为３５．２７％。与全国普查６０岁以上人群高血压患病率接近，男女患病率分别为４２．０３％和２７．５％，男性显著高于女性。结论 根据领导干部高血压     

药品行政保护品种介绍——抗感染药物(二)(续一)

头孢米诺钠通用名:头孢米诺(cefminox),化学名:(+)-(6R,7S)-7-[(S)-2-(2-氨基-2-羧酸乙硫基)乙酰胺基]-7-甲氧基-3-[[(1-甲基-1H-四唑-5-基)硫甲基]-8-氧代-5-硫杂-1-氮杂二环[4,2,0]辛-2-烯-2-羧酸钠七水合物,结构式见图1.     

药品行政保护品种介绍——心血管系统药物(一)(待续)

盐酸地拉普利通用名：盐酸地拉普利(delapril hydrochloride)，商品 名：压得克(Adecut)片剂。化学名：N-{N-［(S)-1-乙氧羰基-3-苯基丙基］-L- 丙氨酰}-N-(茚满-2-基)甘氨酸盐酸盐，结构式见图1。     

药品行政保护品种介绍:抗感染药物(三)(续二)

左氧氟沙星通用名:左氧氟沙星(levofloxacin),化学名:(-)-(S)-α- 氟-2,3-二氢-3-甲基-10-(4-甲基-1-哌嗪基)-7-氧-7H-吡啶并[1,2,3-d e][1,4]苯并NFDA9嗪-6-羧酸(含半分子水),结构式见图1.