开发地质统计学时空模型以从不完整的国家数据预测门诊治疗负担。
Developing geostatistical space-time models to predict outpatient treatment burdens from incomplete national data.
作者信息
Gething Peter W, Noor Abdisalan M, Gikandi Priscilla W, Hay Simon I, Nixon Mark S, Snow Robert W, Atkinson Peter M
机构信息
School of Electronics & Computer Science, University of Southampton, Highfield, Southampton, SO17 1BJ, UK.
出版信息
Geogr Anal. 2008 Apr;40(2):167-188. doi: 10.1111/j.1538-4632.2008.00718.x.
Basic health system data such as the number of patients utilising different health facilities and the types of illness for which they are being treated are critical for managing service provision. These data requirements are generally addressed with some form of national Health Management Information System (HMIS) which coordinates the routine collection and compilation of data from national health facilities. HMIS in most developing countries are characterised by widespread under-reporting. Here we present a method to adjust incomplete data to allow prediction of national outpatient treatment burdens. We demonstrate this method with the example of outpatient treatments for malaria within the Kenyan HMIS. Three alternative modelling frameworks were developed and tested in which space-time geostatistical prediction algorithms were used to predict the monthly tally of treatments for presumed malaria cases (MC) at facilities where such records were missing. Models were compared by a cross-validation exercise and the model found to most accurately predict MC incorporated available data on the total number of patients visiting each facility each month. A space-time stochastic simulation framework to accompany this model was developed and tested in order to provide estimates of both local and regional prediction uncertainty. The level of accuracy provided by the predictive model, and the accompanying estimates of uncertainty around the predictions, demonstrate how this tool can mitigate the uncertainties caused by missing data, substantially enhancing the utility of existing HMIS data to health-service decision-makers.
诸如使用不同卫生设施的患者数量以及他们所接受治疗的疾病类型等基本卫生系统数据,对于管理服务提供至关重要。这些数据需求通常通过某种形式的国家卫生管理信息系统(HMIS)来满足,该系统负责协调从国家卫生设施进行的数据常规收集和汇编工作。大多数发展中国家的HMIS都存在普遍漏报的特点。在此,我们提出一种调整不完整数据的方法,以便预测国家门诊治疗负担。我们以肯尼亚HMIS中疟疾门诊治疗为例展示了这种方法。开发并测试了三种替代建模框架,其中使用时空地理统计预测算法来预测在缺少此类记录的设施中假定疟疾病例(MC)的每月治疗计数。通过交叉验证练习对模型进行比较,发现最能准确预测MC的模型纳入了每个设施每月就诊患者总数的可用数据。为该模型开发并测试了一个时空随机模拟框架,以便提供局部和区域预测不确定性的估计。预测模型提供的准确性水平以及预测周围不确定性的伴随估计,展示了该工具如何减轻缺失数据造成的不确定性,从而大幅提高现有HMIS数据对卫生服务决策者有用性。