A population‐based approach to reporting system‐level performance measures for rheumatoid arthritis care

Objective We evaluated 4 national rheumatoid arthritis (RA) system-level performance measures (PMs) in Alberta, Canada. Methods Incident and prevalent RA cases ≥ 16 years of age since 2002 were identified using a validated case definition applied in provincial administrative data. Performance was ascertained through analysis of health data between fiscal years 2012/13-2015/16. Measures evaluated were: proportion of incident RA cases with a rheumatologist visit within one year of first RA diagnosis code (PM1); proportion of prevalent RA patients dispensed a disease modifying anti-rheumatic drug (DMARD) annually (PM2); time from first visit with an RA code to DMARD dispensation, and proportion of incident cases where the 14-day benchmark for dispensation was met (PM3); and proportion of patients seen in annual follow-up (PM4). Results There were 31566 prevalent and 2730 incident RA cases (2012/13). Over the analysis period, the proportion of patients seen by a rheumatologist within 1 year of onset (PM1) increased from 55 to 63%; however, the proportion of RA patients dispensed DMARDs annually (PM2) remained low at 43%. While the median time to DMARD from first visit date in people who received DMARDs improved over time from 39 to 28 days, only 38-41% of patients received treatment within the 14-day benchmark (PM3). The percentage of patients seen in yearly follow-up (PM4) varied between 73-80%. Conclusion The existing Alberta health care system for RA is suboptimal, indicating barriers to accessing specialty care and treatment. The results inform quality improvement initiatives required within the province to meet national standards of care.

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High Adherence to System-Level Performance Measures for Rheumatoid Arthritis in a National Early Arthritis Cohort Over Eight Years

Arthritis Care & Research ◽

10.1002/acr.23439 ◽

2018 ◽

Vol 70 (6) ◽

pp. 842-850 ◽

Cited By ~ 5

Author(s):

Claire E. H. Barber ◽

Orit Schieir ◽

Diane Lacaille ◽

Deborah A. Marshall ◽

Cheryl Barnabe ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Performance Measures ◽

Early Arthritis ◽

System Level ◽

High Adherence ◽

Level Performance

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A Transportation Performance Measurement System with a Mississippi Case Study

Journal of the Transportation Research Forum ◽

10.5399/osu/jtrf.45.3.606 ◽

2010 ◽

Cited By ~ 1

Author(s):

Haiyuan Wang ◽

Mingzhou Jin

Keyword(s):

Performance Measures ◽

Transportation Systems ◽

System Level ◽

Performance Measurement System ◽

Intermodal Transportation ◽

Design Alternatives ◽

Level Performance ◽

Existing Data ◽

Highway System

In current literature and practices, there are no systematic and user-oriented intermodal transportation performance measures. After identifying customer needs and transportation goals, this paper proposes a set of system-level performance measures for intermodal transportation that are user-oriented, scalable, systematic, and scientific. The measures can be used to compare intermodal design alternatives or to evaluate existing transportation systems with any size and any mode. The highway system in Mississippi is analyzed as a case study. The case study demonstrates the existing data sources, the methods of calculating the measures, and the means of evaluating transportation systems with the measures.

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Acute mental health service use is increased in rheumatoid arthritis and ankylosing spondylitis: a population-based cohort study

Therapeutic Advances in Musculoskeletal Disease ◽

10.1177/1759720x20921710 ◽

2020 ◽

Vol 12 ◽

pp. 1759720X2092171

Author(s):

Bindee Kuriya ◽

Vivian Tia ◽

Jin Luo ◽

Jessica Widdifield ◽

Simone Vigod ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Mental Health ◽

Ankylosing Spondylitis ◽

Health Service ◽

Service Use ◽

Population Based ◽

System Level ◽

Health Service Use ◽

Increased Risk ◽

Ed Visits

Background: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are associated with mental illness. Whether acute mental health (MH) service utilization (i.e. emergency visits or hospitalizations) is increased in RA or AS is not known. Methods: Two population-based cohorts were created where individuals with RA ( n = 53,240) or AS ( n = 13,964) were each matched by age, sex, and year to unaffected comparators (2002–2016). Incidence rates per 1000 person-years (PY) were calculated for a first MH emergency department (ED) presentation or MH hospitalization. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated, adjusting for demographic, clinical, and health service use variables. Results: Individuals with RA had higher rates of ED visits [6.59/1000 person-years (PY) versus 4.39/1000 PY in comparators] and hospitalizations for MH (3.11/1000 PY versus 1.80/1000 PY in comparators). Higher rates of ED visits (7.92/1000 PY versus 5.62/1000 PY in comparators) and hospitalizations (3.03/1000 PY versus 1.94/1000 PY in comparators) were also observed in AS. Overall, RA was associated with a 34% increased risk for MH hospitalization (HR 1.34, 95% CI 1.22–1.47) and AS was associated with a 36% increased risk of hospitalization (HR 1.36, 95% CI 1.12–1.63). The risk of ED presentation was attenuated, but remained significant, after adjustment in both RA (HR 1.08, 95% CI 1.01–1.15) and AS (HR 1.14, 95% CI 1.02–1.28). Conclusions: RA and AS are both independently associated with a higher rate and risk of acute ED presentations and hospitalizations for mental health conditions. These findings underscore the need for routine evaluation of MH as part of the management of chronic inflammatory arthritis. Additional research is needed to identify the underlying individual characteristics, as well as system-level variation, which may explain these differences, and to help plan interventions to make MH service use more responsive to the needs of individuals living with RA and AS.

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Development of System-level Performance Measures for Evaluation of Models of Care for Inflammatory Arthritis in Canada

The Journal of Rheumatology ◽

10.3899/jrheum.150839 ◽

2016 ◽

Vol 43 (3) ◽

pp. 530-540 ◽

Cited By ~ 33

Author(s):

Claire E.H. Barber ◽

Deborah A. Marshall ◽

Dianne P. Mosher ◽

Pooneh Akhavan ◽

Lori Tucker ◽

...

Keyword(s):

Performance Measures ◽

Inflammatory Arthritis ◽

Waiting Times ◽

Models Of Care ◽

System Level ◽

Allied Health Professionals ◽

Modified Delphi ◽

Timely Access ◽

Care Systems ◽

Level Performance

Objective.To develop system-level performance measures for evaluating the care of patients with inflammatory arthritis (IA), including rheumatoid arthritis (RA), psoriatic arthritis, ankylosing spondylitis, and juvenile idiopathic arthritis.Methods.This study involved several methodological phases. Over multiple rounds, various participants were asked to help define a set of candidate measurement themes. A systematic search was conducted of existing guidelines and measures. A set of 6 performance measures was defined and presented to 50 people, including patients with IA, rheumatologists, allied health professionals, and researchers using a 3-round, online, modified Delphi process. Participants rated the validity, feasibility, relevance, and likelihood of use of the measures. Measures with median ratings ≥ 7 for validity and relevance were included in the final set.Results.Six performance measures were developed evaluating the following aspects of care, with each measure being applied separately for each type of IA except where specified: waiting times for rheumatology consultation for patients with new onset IA, percentage of patients with IA seen by a rheumatologist, percentage of patients with IA seen in yearly followup by a rheumatologist, percentage of patients with RA treated with a disease-modifying antirheumatic drug (DMARD), time to DMARD therapy in RA, and number of rheumatologists per capita.Conclusion.The first set of system-level performance measures for IA care in Canada has been developed with broad input. The measures focus on timely access to care and initiation of appropriate treatment for patients with IA, and are likely to be of interest to other arthritis care systems internationally.

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System Level Performance Measures of Recovery

PsycEXTRA Dataset ◽

10.1037/e548622012-001 ◽

2003 ◽

Author(s):

Steven Onken ◽

Jeanne Dumont ◽

Priscilla Ridgeway ◽

Doug Dornan ◽

Ruth Ralph

Keyword(s):

Performance Measures ◽

System Level ◽

Level Performance

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Applying System-Level Performance Measures and Targets in the Detroit, Michigan, Metropolitan Planning Process

Transportation Research Record Journal of the Transportation Research Board ◽

10.3141/2119-04 ◽

2009 ◽

Vol 2119 (1) ◽

pp. 27-35 ◽

Cited By ~ 2

Author(s):

Joseph A. Guerre ◽

Jennifer Evans

Keyword(s):

Performance Measures ◽

Planning Process ◽

System Level ◽

Metropolitan Planning ◽

Level Performance

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On-the-fly scheduling versus reservation-based scheduling for unpredictable workflows

The International Journal of High Performance Computing Applications ◽

10.1177/1094342019841681 ◽

2019 ◽

Vol 33 (6) ◽

pp. 1140-1158 ◽

Cited By ~ 3

Author(s):

Ana Gainaru ◽

Hongyang Sun ◽

Guillaume Aupy ◽

Yuankai Huo ◽

Bennett A Landman ◽

...

Keyword(s):

Performance Measures ◽

Data Centers ◽

Large Data ◽

Large Data Sets ◽

System Level ◽

Data Sets ◽

Data Set ◽

System Utilization ◽

Average Stretch ◽

Level Performance

Scientific insights in the coming decade will clearly depend on the effective processing of large data sets generated by dynamic heterogeneous applications typical of workflows in large data centers or of emerging fields like neuroscience. In this article, we show how these big data workflows have a unique set of characteristics that pose challenges for leveraging HPC methodologies, particularly in scheduling. Our findings indicate that execution times for these workflows are highly unpredictable and are not correlated with the size of the data set involved or the precise functions used in the analysis. We characterize this inherent variability and sketch the need for new scheduling approaches by quantifying significant gaps in achievable performance. Through simulations, we show how on-the-fly scheduling approaches can deliver benefits in both system-level and user-level performance measures. On average, we find improvements of up to 35% in system utilization and up to 45% in average stretch of the applications, illustrating the potential of increasing performance through new scheduling approaches.

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