Johnson K F
Health Prog. 1987 Oct;68(8):46-9, 82.
Healthcare industry changes during the 1980s--increased competition and alterations in the Medicare payment methodology--place new and more complex demands on a hospital's information systems, which often fall short of meeting those demands. These systems were designed for financial reporting, billing, or providing clinical data, and few of them are capable of linking with other unrelated systems. Today's hospital manager needs timely and simultaneous access to data from a variety of sources within the hospital. All the elements to accomplish this are collected somewhere in the hospital, but finding them and bringing them together is difficult. The key to the efficient management and use of data bases is in understanding the fundamental concept of relational data bases, which is the capability of linking or joining separate data files through a common data element in each file. In this way, data files may be integrated into a "related" data base. Any number of separate files, or tables, may exist within a "relational" data base as long as a series of threads links them. A strategic management information data base includes the information necessary to analyze, understand, and manage the hospital's markets, products, resources, and profitability. The major components of this information system are the case mix and cost accounting, budgeting, and modeling systems. The case mix and cost accounting factors involve managing concrete pieces of data, whereas the budgeting and modeling factors manipulate data to create a scenario. The strategic management information data base is the foundation of a hospital's decision support system, which is rapidly moving into the category of a necessary tool of the hospital manager's trade.
20世纪80年代医疗行业的变革——竞争加剧以及医疗保险支付方式的改变——对医院信息系统提出了新的、更为复杂的要求，而这些系统往往无法满足这些需求。这些系统是为财务报告、计费或提供临床数据而设计的，很少有系统能够与其他不相关的系统相连接。如今的医院管理者需要及时、同时获取来自医院内各种来源的数据。实现这一目标所需的所有要素都收集在医院的某个地方，但要找到并整合它们却很困难。高效管理和使用数据库的关键在于理解关系数据库的基本概念，即通过每个文件中的公共数据元素链接或连接单独数据文件的能力。通过这种方式，数据文件可以集成到一个“相关”数据库中。只要有一系列线索将它们链接起来，“关系”数据库中就可以存在任意数量的单独文件或表。战略管理信息数据库包括分析、理解和管理医院的市场、产品、资源和盈利能力所需的信息。这个信息系统的主要组成部分是病例组合与成本核算、预算编制和建模系统。病例组合与成本核算因素涉及管理具体的数据片段，而预算编制和建模因素则操纵数据以创建一个场景。战略管理信息数据库是医院决策支持系统的基础，而决策支持系统正迅速成为医院管理者业务中必备工具的范畴。
