McCormick K, Renner A L, Mayes R, Regan J, Greenberg M
Center for Information Technology, Agency for Health Care Policy and Research, Rockville, MD 20852, USA.
Comput Nurs. 1997 Mar-Apr;15(2 Suppl):S23-32.
This article presents a picture of federal and private efforts in defining minimum data sets and core data elements for health care. For more than 25 years the Federal Government has been engaged in extensive development of minimum data sets and core health data elements. As a major collector and processor of health data, the government identifies, defines, and implements standardized data in the health care field for describing data such as mortality, morbidity, and infectious diseases of the population. This article reports on 17 minimum data sets and core health data elements that are published or in draft form in health care to date. They include regulated data elements that are needed for reimbursement from the Health Care Financing Administration and core health data elements from the Health Resources and Services Administration. They also include recommended data elements for better reporting to the government, and private sector initiatives that are under development, being researched, or in use to standardize data collection for assessing access, quality, and costs of health care. This significant framework can be used in furthering research on the development of the computer-based patient record, the acceleration of data standards, and the evaluation of vocabulary in health care.
本文介绍了联邦政府和私营部门在定义医疗保健最低数据集和核心数据元素方面所做的努力。25多年来，联邦政府一直致力于广泛开发最低数据集和核心健康数据元素。作为健康数据的主要收集者和处理者，政府在医疗保健领域识别、定义并实施标准化数据，以描述诸如人口死亡率、发病率和传染病等数据。本文报道了迄今为止在医疗保健领域已发布或处于草案形式的17个最低数据集和核心健康数据元素。它们包括医疗保健财务管理局报销所需的受监管数据元素以及卫生资源和服务管理局的核心健康数据元素。它们还包括为更好地向政府报告而推荐的数据元素，以及正在开发、研究或用于标准化数据收集以评估医疗保健的可及性、质量和成本的私营部门举措。这一重要框架可用于推动基于计算机的患者记录开发研究、加速数据标准制定以及评估医疗保健领域的词汇。
