Novel Methods of Measuring Health Disparities

描述(由申请人提供)： 本申请涉及NHLBI参与美国国立卫生研究院研究和研究基础设施“重大机遇”(RFA-OD-09-004)；NHLBI RC2主题领域“衡量健康差距的新方法”。该项目的广泛目标是设计一个以人口为基础的监测系统，整合多种数据来源，以追踪地方一级慢性病的差异。这一系统将捕获从社会经济背景和健康风险因素到疾病发病率以及随后的住院、门诊和干预措施的使用和遵守的一连串相关信息。该项目将在华盛顿州金县展示该系统的成本和可行性。通过在这个为期两年的项目中展示这种具有成本效益的综合系统的可行性，它可以随后在美国各地的许多地点部署。这些网站将共同提供有关该国不同地区种族/族裔群体慢性疾病差异的重要细节。集成的多源数据系统将需要某些关键属性。首先，它应该利用现有的数据系统，包括医疗记录出院系统、生命登记数据、人口普查数据、可报告的条件、付款人数据系统和医疗保险文件。其次，它应该用额外的成本效益高的数据收集来补充这些来源，包括家庭调查和图表提取。第三，应通过跨数据平台的记录联系，最大限度地提高信息的质量和效用。最后，在金县使用的方法和策略应该适用于美国各地的不同社区。 公共卫生相关性： 跟踪和分析各县或地方社区的种族/族裔群体的差异，需要对至少四个关键领域进行详细的衡量：健康结果、健康风险因素、健康服务和社会经济背景。该项目的广泛目标是设计一个以人口为基础的监测系统，综合多种数据来源，跟踪地方一级慢性病的差异。这将允许更有针对性地分配有限的资源和更详细、更具体的信息，供政策制定者用来设计适当的干预措施。

DESCRIPTION (provided by applicant): This application addresses NHLBI Participation in NIH Research and Research Infrastructure "Grand Opportunities" (RC2) (RFA-OD-09-004); NHLBI RC2 topic area "Novel Methods of Measuring Health Disparities." The broad goal of this project is to design a population-based surveillance system that integrates multiple data sources to track disparities in chronic diseases at the local level. This system will capture the complete spectrum of relevant information from socio-economic context and health risk factors to disease incidence and the consequent cascade of hospitalizations, outpatient visits, and use of and adherence to interventions. The project will demonstrate the costs and feasibility of this system in King County, Washington. By demonstrating in this two-year project, the feasibility of such an integrated cost-effective system, it could be subsequently deployed in a number of sites across the United States. Together these sites would provide important detail on chronic disease disparities for race/ethnicity groups in different parts of the country. The integrated multi-source data system will need certain key attributes. First, it should leverage existing data systems including medical record discharge systems, vital registration data, census data, reportable conditions, payer data systems and Medicare files. Second, it should supplement these sources with additional cost-effective data collection including household surveys and chart extraction. Third, the quality and utility of the information should be maximized through record linkage across data platforms. Finally, the methods and strategies used in King County should be applicable in diverse communities across the US. PUBLIC HEALTH RELEVANCE: Tracking and analyzing the disparities for race/ethnicity groups across counties or local communities requires detailed measurements for at least four critical domains: health outcomes, health risk factors, health services, and the socio-economic context. The broad goal of this project is to design a population-based surveillance system that integrates multiple -data sources to track disparities in chronic diseases at the local level. This will allow more targeted allocation of limited resources and more detailed, specific information that can be used by policy makers to design appropriate interventions.