Roos Leslie L, Menec Verena, Currie R J
Manitoba Centre for Health Policy, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada R3E 3P5.
Soc Sci Med. 2004 Jun;58(11):2231-41. doi: 10.1016/j.socscimed.2003.08.008.
Population-based insurance systems using longitudinal administrative data and record linkage techniques have helped create "information-rich" environments in several sites around the world. The output of five research groups using administrative data (Oxford, Western Australia, and three Canadian centres: Manitoba, Ontario and British Columbia) was analysed from contacts with the research groups and through use of the National Library of Medicine's PubMed and Medical Subject Headings (MeSH) categories. MeSH words "utilization", "economics", "physicians", and "physician practice patterns" more frequently characterized the research by the three Canadian centres than that of the other sites. With core funding for deliverables negotiated with the provincial health ministries, Canadian researchers have been more likely to use linked databases for policy analyses. Manitoba examples highlight the capabilities associated with these information-rich environments. They include the ability to analyse interventions longitudinally; to compare regions, areas and hospitals in defined populations; to combine information on patients and physicians; to add up expenditures for different services within the Canadian health-care system; and to examine population health issues in areas such as education and family services. Well-organized data and the capability for rapid response have been critical for timely policy analysis in Manitoba. A number of successes are mentioned; less successful efforts to influence practice patterns and to modify the internal workings of hospitals are noted. Investments in filling gaps in data collection and in enriching existing data would facilitate additional research. Planning and managing health care for an entire population has benefited greatly from the development of an information-rich environment.
利用纵向管理数据和记录链接技术的基于人群的保险系统，已在全球多个地方助力营造了“信息丰富”的环境。通过与五个使用管理数据的研究团队（牛津、西澳大利亚以及加拿大的三个中心：曼尼托巴、安大略和不列颠哥伦比亚）进行沟通，并借助美国国立医学图书馆的《医学主题词表》（MeSH）类目，对这些团队的研究成果进行了分析。与其他研究点相比，MeSH词“利用”“经济学”“医生”和“医生执业模式”在加拿大三个中心的研究中出现得更为频繁。由于与省级卫生部就可交付成果的核心资金进行了协商，加拿大研究人员更有可能使用链接数据库进行政策分析。曼尼托巴的实例彰显了与这些信息丰富环境相关的能力。这些能力包括纵向分析干预措施的能力；比较特定人群中的不同地区、区域和医院的能力；整合患者和医生信息的能力；汇总加拿大医疗保健系统内不同服务支出的能力；以及研究教育和家庭服务等领域的人群健康问题的能力。组织良好的数据以及快速响应能力对于曼尼托巴及时进行政策分析至关重要。文中提到了一些成功案例；也指出了在影响执业模式和改变医院内部运作方面不太成功的努力。在填补数据收集空白和充实现有数据方面进行投资，将有助于开展更多研究。为整个人口规划和管理医疗保健，已从信息丰富环境的发展中受益匪浅。
