Abstract
The developments in outcomes research and community health information systems are pursuing essentially parallel courses in this country, and yet integrating the lessons from each other could yield more informed health policy decisions. This article provides the linkage between these two developing fields, discusses indicators of community health, describes several approximations to an outcomes-based community health information system in this country, and specifies a model (POPULIS) of such a system from Canada. Although POPULIS can serve as a prototype for health policy decision making, the outcomes-based community health information system, which can be constructed in this country, is constrained by the pluralistic system of health care we have and the lack of any centralized planning about health.
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REFERENCES
Slater, C. What is outcomes research and what can it tell us? Evaluation and the Health Professions 20:243–64, 1997.
Aday, L.A., Begley, C.E., Lairson, D.R., et al., Evaluating the Healthcare system: Effectiveness, Efficiency, and Equity (2nd Ed.), Health Administration Press, Chicago, 1998.
Hansluwka, H., Measuring the health of populations, indicators and interpretations. Soc. Sci. Med. 20:1207–24, 1985.
Flower, J., Building healthier cities. Healthcare Forum J. 48–54, 75, 1993.
Hancock, T., and Duhl, L.J., Promoting Health in the Urban Context, WHO Healthy Cities Project; Copenhagen 1988 (WHO Healthy Cities Papers; Vol. 1).
Institute of Medicine. The Future of Public Health. National Academy Press, Washington, D.C.: 1988.
National Center for Health Statistics. Healthy People 2000—Midcourse Review and 1995 Revisions. Public Health Service, Hyattsville, MD, 1995.
Donabedian A. Evaluating the quality of medical care. Milbank Q 44 (Part 2):166–206, 1966.
Kindig, D.A., Purchasing Population Health: Paying for Results, University of Michigan Press, Ann Arbor, 1997.
Chiang, C., and Cohen, R., How to measure health: a stochastic model for an index of health. Int. J. Epidem. 2:7–13, 1973.
Sullivan, D.F., Conceptual problems in developing an index of health. National Center for Health Statistics, Rockville, MD, 1966, Series 2: Number 17(PHS No. 1000).
Torrance, G., Measurement of health state utilities for economic appraisal—a review. J Health Economics 5:1–30, 1986.
Murray, C.J.L., and Lopez, A.D. (eds.), The global burden of disease: A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Harvard School of Public Health on behalf of the World Health Organization and the World Bank, Cambridge, MA, 1996.
Erickson, P., Wilson, R., and Shannon, I., Years of Healthy Life, National Center for Health Statistics, Hyattsville, MD, 1995 (Healthy People 2000 Statistical Notes).
Centers for Disease Control. Consensus set of health status indicators for the general assessment of community health status—United States. Morbidity Mortality Weekly Rep. 40:449–51, 1991.
National Center for Health Statistics. Health status indicators: Definitions and national data. Healthy People 2000 Statistical Notes 1(3):1–8, 1992.
National Center for Health Statistics. Healthy People 2000 Review, 1995–96, Public Health Service, Hyattsville, MD, 1996.
Institute of Medicine. Improving health in the community: A role for performance monitoring. National Academy Press, Washington, D.C. 1997.
U.S. Health Corporation. U.S. Health Corporation's Health Community Initiative: The Healthy Community Assessment Process, U.S. Health Corporation, Denver, CO, 1994.
Aday, L.A., At risk in America: The health and health care needs of vulnerable populations in the United States. Jossey-Bass Publishers, San Francisco, 1993.
Cohen, M., MacWilliam, L., Measuring the health of the population. Med. Care 33:DS21–DS42, 1995.
Fitzsimmons, S., and Lavey, W., Social Economic Accounts System (SEAS): toward a comprehensive, community-level assessment procedure. Social Indicators Research 2:389–452, 1976.
National Association of County Health Officers. Assessment Protocol for Excellence in Public Health (APEXPH). National Association of County Health Officers, Washington, DC, 1991.
Shortell, S., Gillies, R., and Devers, K., Reinventing the American hospital. Milbank Q, 73:131–60, 1995.
Evans, R.G., and Stoddart, G.L., Producing health, consuming health care. In (R.G. Evans, M.L. Barer, T.R. Marmor, eds.), Why Are Some People Healthy and Others Not? The Determinants of Health of Populations, Aldine De Gruyter, New York, 1994, pp. 27–64.
Wolfson, M., A template for health information. World Health Stat. Q. 45:109–13, 1992.
Morris, J.N., Uses of Epidemiology, Churchill Livingstone, Edinburgh, 1975.
Zimmer, J., and Puskin, D., An epidemiological model of the natural history of a disease within a multilevel care system. Int. J. Epidemiol. 4:93–104, 1975.
Acheson, E.D., Introduction. In (J.S. Baldwin, E.D. Acheson, W.J. Graham, eds.), Textbook of medical record linkage. Oxford University Press, New York, 1987, pp. 1–12.
Gill, L., Goldacre, M., Simmons, H., Bettley, G., and Griffith, M., Computerised linking of medical records: methodological guidelines. J. Epidemiol. Commun. Health 47:316–9, 1993.
Jones, M., Swerdlow, A., Gill, L. and Goldacre, M., Pre-natal and early life risk factors for childhood onset diabetes mellitus: a record linkage study. Int. J. Epidemiol. 27:444–9, 1998.
Jones, M., Swerdlow, A., Griffith, M., and Goldacre, M., Risk of congenital inguinal hernia in siblings: a record linkage study. Paediatr. Perinat. Epidemiol. 12:288–96, 1998.
Roos, N., Black, C., Frohlich, N., et al., A population-based health information system. Med. Care 33:DS13–20, 1995.
Billings, J., Zeitel, L., Lutomnik, J., Carey, T., Blank, A.E., and Newman, L., Impact of socioeconomic status on hospital use in New York City. Health Aff. (Millwood) 12(1):162–73, 1993.
Weissman, J., Gatsonis, C., and Epstein, A., Rates of avoidable hospitzalization by insurance status in Massachusetts and Maryland. JAMA 268:2388–94, 1992.
Charlton, J., Silver, R., Hartley, R., and Holland, W., Geographical variation in mortality from conditions amenable to medical intervention in England and Wales. Lancet 1:691–6, 1983.
Agency for Health Care Policy and Research., AHCPR Home Page. http://www.ahcpr.gov:80/
Continuum. Health Status and Health Care. http://www.sph.uth.tmc.edu/www/res/outcomes/html/continuum.htm.
Episcopal Health Charities. Community Health Information System (CHIS), http://www.sph.uth.tmc.edu:8051/
National Center for Health Statistics, Healthy People 2000 Home Page, http://odphp.osophs.dhhs.gov/pubs/hp2000/
POPULIS. Manitoba Centre for Health Policy and Evaluation (MCHPE), http://www.Umanitoba.ca./centres/mchpe/1mchpe.htm
Slater, CH. Outcomes Assessment and Research, http://www.sph.uth.tmc.edu/www/res/outcomes/outcomes.htm
Wolfson, M. Template for Health Information, http://www.sph.uth.tmc.edu:8051/chis1/chrc/set.htm
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Slater, C.H. Outcomes Research and Community Health Information Systems. Journal of Medical Systems 23, 335–347 (1999). https://doi.org/10.1023/A:1020582412446
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DOI: https://doi.org/10.1023/A:1020582412446