使用本体论促进更准确地编码解决健康社会决定因素的社会处方：可行性研究。
Using an Ontology to Facilitate More Accurate Coding of Social Prescriptions Addressing Social Determinants of Health: Feasibility Study.
机构信息
Oxford Martin School, University of Oxford, Oxford, United Kingdom.
Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
出版信息
J Med Internet Res. 2020 Dec 11;22(12):e23721. doi: 10.2196/23721.
BACKGROUND
National Health Service (NHS) England supports social prescribing in order to address social determinants of health, which account for approximately 80% of all health outcomes. Nevertheless, data on ongoing social prescribing activities are lacking. Although NHS England has attempted to overcome this problem by recommending 3 standardized primary care codes, these codes do not capture the social prescribing activity to a level of granularity that would allow for fair attribution of outcomes to social prescribing.
OBJECTIVE
In this study, we explored whether an alternative approach to coding social prescribing activity, specifically through a social prescribing ontology, can be used to capture the social prescriptions used in primary care in greater detail.
METHODS
The social prescribing ontology, implemented according to the Web Ontology Language, was designed to cover several key concepts encompassing social determinants of health. Readv2 and Clinical Terms Version 3 codes were identified using the NHS Terms Browser. The Royal College of General Practitioners Research Surveillance Centre, a sentinel network of over 1000 primary care practices across England covering a population of more than 4,000,000 registered patients, was used for data analyses for a defined period (ie, January 2011 to December 2019).
RESULTS
In all, 668 codes capturing social prescriptions addressing different social determinants of health were identified for the social prescribing ontology. For the study period, social prescribing ontology codes were used 5,504,037 times by primary care practices of the Royal College of General Practitioners Research Surveillance Centre as compared to 29,606 instances of use of social prescribing codes, including NHS England's recommended codes.
CONCLUSIONS
A social prescribing ontology provides a powerful alternative to the codes currently recommended by NHS England to capture detailed social prescribing activity in England. The more detailed information thus obtained will allow for explorations about whether outputs or outcomes of care delivery can be attributed to social prescriptions, which is essential for demonstrating the overall value that social prescribing can deliver to the NHS and health care systems.
背景
英国国民保健制度（NHS）支持社会处方，以解决健康的社会决定因素，这些因素约占所有健康结果的 80%。然而，目前缺乏关于正在进行的社会处方活动的数据。尽管英国国民保健制度曾试图通过推荐 3 种标准化的初级保健代码来解决这个问题，但这些代码并没有详细记录社会处方活动，无法将结果公平归因于社会处方。
目的
在这项研究中，我们探讨了一种替代方法来对社会处方活动进行编码，特别是通过社会处方本体，是否可以更详细地记录初级保健中使用的社会处方。
方法
根据 Web 本体语言实施的社会处方本体旨在涵盖涵盖健康的社会决定因素的几个关键概念。使用 NHS 术语浏览器识别 Readv2 和临床术语版本 3 代码。皇家全科医生研究监测中心是一个由英格兰 1000 多家初级保健实践组成的监测网络，覆盖了超过 400 万注册患者，用于在一个定义的时间段内（即 2011 年 1 月至 2019 年 12 月）进行数据分析。
结果
总共为社会处方本体确定了 668 个用于解决不同健康社会决定因素的社会处方代码。在研究期间，与使用社会处方代码的 29606 次相比，皇家全科医生研究监测中心的初级保健实践使用社会处方本体代码的次数为 5504037 次，包括英国国民保健制度推荐的代码。
结论
社会处方本体为英国国民保健制度目前推荐的代码提供了一种强大的替代方法，以记录英格兰详细的社会处方活动。因此获得的更详细信息将允许探索是否可以将护理交付的产出或结果归因于社会处方，这对于证明社会处方可以为国民保健制度和医疗保健系统带来的总体价值至关重要。
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