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首页> 外文期刊>BMC Medical Informatics and Decision Making >HERALD (Health Economics using Routine Anonymised Linked Data)
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HERALD (Health Economics using Routine Anonymised Linked Data)

机译：HERALD（使用常规匿名链接数据的卫生经济学）

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Background Health economic analysis traditionally relies on patient derived questionnaire data, routine datasets, and outcomes data from experimental randomised control trials and other clinical studies, which are generally used as stand-alone datasets. Herein, we outline the potential implications of linking these datasets to give one single joined up data-resource for health economic analysis. Method The linkage of individual level data from questionnaires with routinely-captured health care data allows the entire patient journey to be mapped both retrospectively and prospectively. We illustrate this with examples from an Ankylosing Spondylitis (AS) cohort by linking patient reported study dataset with the routinely collected general practitioner (GP) data, inpatient (IP) and outpatient (OP) datasets, and Accident and Emergency department data in Wales. The linked data system allows: (1) retrospective and prospective tracking of patient pathways through multiple healthcare facilities; (2) validation and clarification of patient-reported recall data, complementing the questionnaire/routine data information; (3) obtaining objective measure of the costs of chronic conditions for a longer time horizon, and during the pre-diagnosis period; (4) assessment of health service usage, referral histories, prescribed drugs and co-morbidities; and (5) profiling and stratification of patients relating to disease manifestation, lifestyles, co-morbidities, and associated costs. Results Using the GP data system we tracked about 183 AS patients retrospectively and prospectively from the date of questionnaire completion to gather the following information: (a) number of GP events; (b) presence of a GP 'drug' read codes; and (c) the presence of a GP 'diagnostic' read codes. We tracked 236 and 296 AS patients through the OP and IP data systems respectively to count the number of OP visits; and IP admissions and duration. The results are presented under several patient stratification schemes based on disease severity, functions, age, sex, and the onset of disease symptoms. Conclusion The linked data system offers unique opportunities for enhanced longitudinal health economic analysis not possible through the use of traditional isolated datasets. Additionally, this data linkage provides important information to improve diagnostic and referral pathways, and thus helps maximise clinical efficiency and efficiency in the use of resources.
机译：背景技术传统上，卫生经济分析依赖于患者衍生的调查表数据，常规数据集以及来自实验随机对照试验和其他临床研究的结果数据，这些数据通常用作独立数据集。在此，我们概述了将这些数据集链接以提供一个单独的联合数据资源进行卫生经济分析的潜在含义。方法将调查表中的各个级别数据与常规捕获的医疗保健数据相链接，可以回顾性地和前瞻性地映射整个患者旅程。我们通过将患者报告的研究数据集与常规收集的全科医生（GP）数据，住院患者（IP）和门诊患者（OP）数据集以及威尔士急诊科的数据联系起来，以强直性脊柱炎（AS）队列为例进行说明。链接的数据系统允许：（1）追溯和前瞻性地跟踪通过多个医疗机构的患者路径; （2）验证和澄清患者报告的回忆数据，补充问卷/常规数据信息; （3）在更长的时间范围内以及在预诊断期间获得客观的慢性病成本衡量指标; （4）评估卫生服务的使用情况，转诊历史，处方药和合并症; （5）对患者的疾病表现，生活方式，合并症和相关费用进行剖析和分层。结果从GP数据系统开始，我们从调查表填写之日起追溯性和前瞻性地追踪了183名AS患者，以收集以下信息：（a）GP事件的数量; （b）存在GP“药品”阅读代码; （c）存在GP“可诊断”读取代码。我们分别通过OP和IP数据系统跟踪了236和296名AS患者，以计算OP的就诊次数。以及IP许可和持续时间。根据疾病严重程度，功能，年龄，性别和疾病症状发作，在几种患者分层方案下显示了结果。结论链接的数据系统为增强纵向卫生经济分析提供了独特的机会，而这是使用传统的孤立数据集无法实现的。此外，此数据链接提供了重要信息，可改善诊断和转诊途径，从而帮助最大程度地提高临床效率和资源利用效率。

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