Dataset Information

Describing the current state of post-rehabilitation health system surveillance in Ontario - an invited review.

ABSTRACT: Context: Spinal cord injury (SCI) presents numerous physiological, psychosocial, and environmental complexities resulting in significant healthcare system resource demands. Objective: To describe the current health system surveillance mechanisms in Ontario, Canada and highlight gaps in health surveillance among adults with SCI across their lifespan. Methods: A review of administrative data sources capturing SCI-specific information took place via internet searching and networking among SCI rehabilitation and health services experts with emphasis on functionality, health service utilization, and quality of life data. Results: The review identified a distinct paucity of data elements specific to the health surveillance needs of individuals with SCI living in the community. The gaps identified are: (1) a lack of data usability; (2) inadequate linkage between available datasets; (3) inadequate/infrequent reporting of outcomes; (4) a lack of relevant content/patient-reported outcomes; and, (5) failure to incorporate additional data sources (e.g. Insurance datasets). Conclusion: Currently, SCI-specific health data is disproportionately weighted towards the first 3-6 months post injury with detailed data regarding pre-hospital care, acute management and rehabilitation, but little existing infrastructure supporting community-based health surveillance. Given this reality, the bolstering of meaningful community health surveillance of this population across the lifespan is needed. Addressing the identified gaps in health surveillance must inform the creation of a comprehensive community health dataset incorporating patient-reported outcome measures and enabling linkage with existing administrative and/or clinical databases. A future harmonized data surveillance strategy would, in turn, positively impact function, health services, resource utilization and health-related quality of life surveillance.

SUBMITTER: Rowan CP

PROVIDER: S-EPMC6781471 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Describing the current state of post-rehabilitation health system surveillance in Ontario - an invited review.

Rowan Chip P CP Chan Brian C F BCF Jaglal Susan B SB Catharine Craven B B

The journal of spinal cord medicine 20191001 sup1

Context: Spinal cord injury (SCI) presents numerous physiological, psychosocial, and environmental complexities resulting in significant healthcare system resource demands. Objective: To describe the current health system surveillance mechanisms in Ontario, Canada and highlight gaps in health surveillance among adults with SCI across their lifespan. Methods: A review of administrative data sources capturing SCI-specific information took place via internet searching and netwo ...[more]

PMID: 31573448

Similar Datasets

Project description:Background:Despite its relative rarity, glomerulonephritis (GN) accounts for 20% of prevalent end-stage renal disease patients in Ontario. Early identification and appropriate management of GN to delay progression of disease can reduce patient morbidity and health system costs. As such, a provincial GN needs assessment was conducted to inform on the development of the provincial GN strategic framework in Ontario. Objective:To understand the current state of GN care in Ontario from nephrologist, hospital administrator, and patient and family perspectives. Design:Cross-sectional. Settings:26 regional renal programs in Ontario. Patients:23 patients and family members living with GN who do not require renal replacement therapy. Measurements:Patient and family member interviews as well as a survey of nephrologists. Methods:The study included 3 components: (1) interviews with patients and family members, (2) a survey of nephrologists, and (3) interviews with regional renal programs. The Ontario Renal Network provincial office developed the needs assessment questions and the physician survey questions after consultation with practicing nephrologists and hospital administrators. Thematic analysis was used to assess interview data and descriptive statistics to assess survey data. Results:Interviews with patients and family members (n = 23) identified gaps in care related to diagnosis and referral to nephrology care, education and decision-making, and psychosocial supports. The survey of nephrologists (n = 74) identified various issues that contribute to unstandardized GN care across Ontario, including a lack of provincial expertise in providing complex GN care, access to medication, multidisciplinary team support as well as patient education, and psychosocial supports. Interviews with regional renal programs aligned with interview and survey findings (n = 11). Limitations:Interviews with patients and family members were facilitated by 1 interviewer and limited to 20 interviews due to resource limitations. All nephrologists, patients, and family members who participated in the survey and interviews were volunteers and English-speaking, which may have resulted in self-selection bias. Conclusions:The provincial GN needs assessment emphasized the necessity to develop and implement a provincial GN strategy. The strategic framework includes 4 objectives: (1) ensure patients are supported to make informed decisions, (2) establish a provincial model of care, (3) leverage data to enable planning, decision-making, and monitoring of outcomes, and (4) ensure appropriate access to medication. This is the first Ontario strategy to address provincial gaps in GN care.

Project description:COVID-19 restrictions and the pandemic have affected animal health and food production through the disease's effects on human activities. COVID-19 impact on swine health surveillance can be assessed by investigating submissions and test positivity for pathogens before and after COVID-19 restrictions. PRRSV, Influenza A virus, Mycoplasma hyopneumoniae and PCV-2 are considered important and economically challenging respiratory diseases for the swine populations. By reviewing test results from swine samples submitted for diagnostic testing to a regional diagnostic laboratory, and by assessing total submissions, total positive tests, and the proportion of positive tests at weekly intervals with time series techniques and generalized linear regression models, we evaluated COVID-19's impact on the monitoring of these respiratory pathogens in Ontario, Canada. We classified weeks that fell from week 12 through week 24 in each year as pandemic equivalent weeks and the non-pandemic weeks included all other weeks. The pandemic period in 2020 resulted in a significantly higher number of submissions (p < 0.05) and PRRSV positive submission counts (p < 0.05) when compared to equivalent time periods in previous years; however, no changes could be detected in the odds of weekly PRRSV submission positivity. Weekly positive proportions of PCV-2 tests were higher during the pandemic period in 2020 compared with the pandemic equivalent period in 2018 and 2017. The counts of submissions that requested tests for PRRSV, Influenza A virus and M. hyopneumonia combined, as well as the number of submissions and the proportions of submissions that tested negative for these multiple respiratory pathogens were not significantly different between the pandemic period in 2020 and other periods examined. Our findings indicate that swine producers, in conjunction with various private and public veterinary support services, continued monitoring and performing diagnostic screening on farms for economically important animal diseases despite complications resulting from COVID-19 public health restrictions. PRRSV continues to have a serious impact on swine health. The absence of an increased proportion of negative tests for individual or groups of pathogens, or an accompanying increase in submissions during the 2020 pandemic period suggests that no new undetected pathogens with an impact on respiratory signs in swine were introduced during this time.

Project description:For the prioritization of the allocation of national resources, estimating the burden of disease studies play a critical role. Hence the first Global Burden of Disease study conducted in the 1990s was done for this particular estimation. By the means of introducing disability-adjusted life year (DALY) metric, the burden of various diseases was calculated using disability weights (DWs)-a component of DALY. DWs are values that capture individuals' perception regarding the severity of diseases that involve valuation tools and health state descriptions. Various studies have been conducted over the past few decades to evaluate health states and derive disease-specific disability weights using Person-Trade off, Time-trade off, etc. However, use of these complex and cognitively demanding methods has been carried out in developed countries where the bulk of the populace is more educated. Few attempts have been made in low- and middle-income countries such as India, where not only the majority is less educated but also the social construction of diseases and health conditions are diverse. Therefore, due to the absence of methodological protocols of health state valuations for application at the community-level in the developing world, we attempted to systematically describe the procedure that can be used universally and cross-culturally for various health states. We began with the tentative selection of health states and health states valuation methods by conducting a meticulous literature review, followed by community exploration and medical consultations. This led to developing vignettes (clinical description) and 6D5L pictorial narrations (functional status description). Two field tests for checking the usability and refinement of the tools was done. Final consultation by an expert panel comprising of medical and non-medical professionals was held/conducted to finalize the health state labels and functional status profiles of each health state. The methodical approach provides a robust and thorough procedure for guiding researchers to implement health state valuation studies at community level.

Project description:BackgroundTo date Health information (HI) in the European Union does not comprise indicators or other information related to impacts of hazardous chemicals in consumer products, food, drinking water or air on the health status of the population. Therefore, we inventorised and evaluated the potential of environmental health surveillance and research data sources in the European population to provide HBM-based indicators of internal human exposure and health impact of relevant chemicals.MethodsWe established an up-dated inventory of European cross-sectional Human Biomonitoring (HBM) surveys and of birth cohorts, and compared chemicals and chemical groups addressed by HBM with indicators and health end points collected via European Core Health Indicators (ECHI), in birth registries, as well as in environmental and food data bases and health registries to see on how data collection could be aligned. Finally, we investigated study designs of HBM survey and health examination surveys for potential synergies.ResultsThe inventory covers a total of 11 European cross-sectional national programmes and a large number of birth cohorts and includes information on study population, age groups, covered substances, sampled matrices, and frequency. The comparison of data collections shows that there are many overlaps between environmental chemicals with environmental and health reporting. HBM data could be linked with ECHI indicators for work-related risks, body mass index (BMI), and low birth weight, with perinatal disease, neurologic disorders, and some chronic diseases, or with data bases for e.g. indoor air, food, or consumer products. Existing initiatives to link data collections at European Environment Agency (EEA) and Joint Research Center (JRC) or at World Health Organization (WHO) are good options to further develop linkage of HBM with exposures sources and health end points.ConclusionsThere is potential to use HBM based information in a number of public health policies, and this would help to align reporting to international commitments. Environmental health surveillance based on HBM and HBM-based indicators, is an excellent tool to inform public health policies about risks from environmental chemicals, and the EU health information system would benefit from additional HBM-based indicators for monitoring exposure burden from environmental chemicals. Considerable efforts are needed to align and establish routine data collections and to develop a surveillance system and indicators which may inform public health policies.

Dataset Information

Describing the current state of post-rehabilitation health system surveillance in Ontario - an invited review.

Publications

Describing the current state of post-rehabilitation health system surveillance in Ontario - an invited review.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets