Health data collection methods and procedures across EU member states: findings from the InfAct Joint Action on health information

Developing indicators for medication-related readmissions based on a Delphi consensus study

BACKGROUND

Medication-related readmissions challenge healthcare systems by burdening patients, increasing costs and straining resources. However, to date, there has been no consensus study on indicators for medication-related readmissions.

OBJECTIVES

This Delphi study aimed to develop a consensus-based set of indicators for detecting patients at risk of medication-related readmission.

METHODS

An expert panel of clinical pharmacists, physicians and nursing experts participated in a two-round Delphi study. In round 1, 31 indicators taken from the literature were rated for relevance on a scale from 1 to 9, with a median rating of 7 or higher suggesting relevance. The RAND/UCLA method was used to determine consensus. In round 2, indicators lacking consensus were re-rated together with a series of new indicators generated by the experts. Additional details were sought for some indicators. The main outcomes were the relevance of, consensus on, and completeness of the proposed indicators for identifying risks of 30-day medication-related readmission.

RESULTS

Thirty-eight experts participated in round 1. Consensus was found for all the indicators, with 25 included and 6 excluded. Thirty-four experts participated in round 2. Consensus was found for all 5 newly suggested indicators, and 4 were included. The expert panel prioritized the following indicators: (1) insufficient communication between different healthcare providers, (2) polypharmacy (≥7 medications), (3) low rates of medication adherence (twice-weekly mistakes or missing administration), (4) complex medication regimens (≥3 doses, ≥2 dosage forms and ≥2 administration routes per day), and (5) multimorbidity (≥3 chronic conditions). The final set comprised 29 indicators.

CONCLUSIONS

The indicator set developed for flagging potential medication-related readmissions could guide priorities for clinical pharmacy services at hospital discharge, improving patient outcomes and resource use. A validation study of these indicators is planned.

Uses of Social Determinants of Health Data to Address Cardiovascular Disease and Health Equity: A Scoping Review

Background Cardiovascular disease is the leading cause of morbidity and mortality worldwide. Prior research suggests that social determinants of health have a compounding effect on health and are associated with cardiovascular disease. This scoping review explores what and how social determinants of health data are being used to address cardiovascular disease and improve health equity. Methods and Results After removing duplicate citations, the initial search yielded 4110 articles for screening, and 50 studies were identified for data extraction. Most studies relied on similar data sources for social determinants of health, including geocoded electronic health record data, national survey responses, and census data, and largely focused on health care access and quality, and the neighborhood and built environment. Most focused on developing interventions to improve health care access and quality or characterizing neighborhood risk and individual risk. Conclusions Given that few interventions addressed economic stability, education access and quality, or community context and social risk, the potential for harnessing social determinants of health data to reduce the burden of cardiovascular disease remains unrealized.

Food intake markers in Sisvan: temporal trends in coverage and integration with e-SUS APS, Brazil 2015-2019

Abstract The aim of the present study was to estimate the population coverage of recording food intake markers in Brazil’s Food and Nutrition Surveillance System (Sisvan) and mean annual percent change (APC) in coverage according to the system used for data entry (e-SUS APS and Sisvan Web). We conducted an ecological time series study of the period 2015-2019. The data were stratified into region and age group. APC in coverage was calculated using Prais-Winsten regression and the correlation between APC and HDI, GDP per capita and primary healthcare coverage was assessed using Spearman’s correlation coefficient. Population coverage of recording food intake markers at national level was 0.92% in 2019. Mean APC in coverage throughout the period was 45.63%. The region and age group with the highest coverage rate were the Northeast (4.08%; APC=45.76%, p<0.01) and children aged 2-4 years (3.03%; APC=34.62%, p<0.01), respectively. There was an upward trend in data entry using e-SUS APS, to the detriment of Sisvan Web. There was a positive correlation between APC in coverage using e-SUS APS and HDI and GDP per capita in some age groups. Population coverage of recording Sisvan food intake markers remains low across the country. The e-SUS APS has the potential to be an important strategy for expanding food and nutrition surveillance.

Food intake markers in Sisvan: temporal trends in coverage and integration with e-SUS APS, Brazil 2015-2019

The aim of the present study was to estimate the population coverage of recording food intake markers in Brazil's Food and Nutrition Surveillance System (Sisvan) and mean annual percent change (APC) in coverage according to the system used for data entry (e-SUS APS and Sisvan Web). We conducted an ecological time series study of the period 2015-2019. The data were stratified into region and age group. APC in coverage was calculated using Prais-Winsten regression and the correlation between APC and HDI, GDP per capita and primary healthcare coverage was assessed using Spearman's correlation coefficient. Population coverage of recording food intake markers at national level was 0.92% in 2019. Mean APC in coverage throughout the period was 45.63%. The region and age group with the highest coverage rate were the Northeast (4.08%; APC=45.76%, p<0.01) and children aged 2-4 years (3.03%; APC=34.62%, p<0.01), respectively. There was an upward trend in data entry using e-SUS APS, to the detriment of Sisvan Web. There was a positive correlation between APC in coverage using e-SUS APS and HDI and GDP per capita in some age groups. Population coverage of recording Sisvan food intake markers remains low across the country. The e-SUS APS has the potential to be an important strategy for expanding food and nutrition surveillance.