Roos N P, Black C, Roos L L, Frohlich N, DeCoster C, Mustard C, Brownell M D, Shanahan M, Fergusson P, Toll F, Carriere K C, Burchill C, Fransoo R, MacWilliam L, Bogdanovic B, Friesen D
Manitoba Centre for Health Policy and Evaluation, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Canada.
Med Care. 1999 Jun;37(6 Suppl):JS27-41. doi: 10.1097/00005650-199906001-00007.
University-based researchers in Manitoba, Canada, have used administrative data routinely collected as part of the national health insurance plan to design an integrated database and population-based health information system. This information system is proving useful to policymakers for answering such questions as: Which populations need more physician services? Which need fewer? Are high-risk populations poorly served? or do they have poor health outcomes despite being well served? Does high utilization represent overuse? or is it related to high need? More specifically, this system provides decision makers with the capability to make critical comparisons across regions and subregions of residents' health status, socioeconomic risk characteristics and use of hospitals, nursing homes, and physicians. The system permits analyses of demographic changes, expenditure patterns, and hospital performance in relation to the population served. The integrated database has also facilitated outcomes research across hospitals and countries, utilization review within a single hospital, and longitudinal research on health reform. The discussion highlights the strengths of integrated population-based information in analyzing the health care system and raising important questions about the relationship between health care and health.
加拿大曼尼托巴省的大学研究人员利用作为国家医疗保险计划一部分常规收集的行政数据，设计了一个综合数据库和基于人群的健康信息系统。事实证明，这个信息系统对政策制定者很有用，可用于回答以下问题：哪些人群需要更多的医生服务？哪些人群需要较少的服务？高危人群是否得到了较差的服务？还是尽管得到了良好的服务，但他们的健康状况仍然很差？高利用率是代表过度使用吗？还是与高需求有关？更具体地说，该系统使决策者能够对居民的健康状况、社会经济风险特征以及医院、疗养院和医生的使用情况在不同地区和次区域之间进行关键比较。该系统允许分析人口变化、支出模式以及与所服务人群相关的医院绩效。综合数据库还促进了跨医院和国家的结果研究、单家医院内部的利用情况审查以及关于卫生改革的纵向研究。讨论突出了基于人群的综合信息在分析医疗保健系统以及提出有关医疗保健与健康之间关系的重要问题方面的优势。
