Identifying patterns of non-communicable diseases in developed eastern coastal China: a longitudinal study of electronic health records from 12 public hospitals

ObjectiveFew studies have examined the spectrum and trends of non-communicable diseases (NCDs) in inpatients in eastern coastal China, which is transforming from an industrial economy to a service-oriented economy and is the most economically developed region in the country. This study aimed to dynamically elucidate the spectrum and characteristics of severe NCDs in eastern coastal China by analysing patients’ longitudinal electronic health records (EHRs).SettingTo monitor the spectrum of NCDs dynamically, we extracted the EHR data from 12 general tertiary hospitals in eastern coastal China from 2003 to 2014. The rankings of and trends in the proportions of different NCDs presented by inpatients in different gender and age groups were calculated and analysed.ParticipantsWe obtained a total sample of 1 907 484 inpatients with NCDs from 2003 to 2014, 50.05% of whom were men and 81.53% were aged 50 years or older.ResultsThere was an increase in the number of total NCD inpatients in eastern coastal China from 2003 to 2014. However, the proportion of chronic respiratory diseases and cancer inpatients decreased over the 12-year period. Compared with men, women displayed a significant increase in the proportion of mental and behavioural disorders (p<0.001) over time. Additionally, digestive diseases and sensory organ diseases significantly decreased among men, but not women. The older group accounted for a larger and growing proportion of the NCD inpatients, and the most common conditions in this group were cerebral infarctions, coronary heart disease and hypertension. In addition, the proportion of 21-year-old to 50-year-old inpatients with diabetes, blood diseases or endocrine diseases skyrocketed from 2003 to 2014 (p<0.001).ConclusionsThe burden of inpatients’ NCDs increased rapidly, particularly among women and younger people. The NCD spectrum observed in eastern coastal China is a good source of evidence for developing prevention guides for regions experiencing transition.

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Prevalence of Non-Communicable Diseases and Associated Medication Use Among Syrian Refugees in Lebanon: An Analysis of Country-Wide Data from the Sijilli Electronic Health Records Database

10.21203/rs.3.rs-58159/v1 ◽

2020 ◽

Author(s):

Shadi Saleh ◽

Lina Abdouni ◽

Hani Dimassi ◽

Dana Nabulsi ◽

Ranime Harb ◽

...

Keyword(s):

Cardiovascular Diseases ◽

Electronic Health Records ◽

Medication Use ◽

Communicable Diseases ◽

Syrian Refugees ◽

Health Records ◽

Non Communicable Diseases ◽

Adherence To Medication ◽

Wide Range ◽

Electronic Health

Abstract Background Globally, the number of forcibly displaced individuals has reached 70.8 million. Lebanon, a middle income country, hosts the highest number of refugees per capita worldwide. The majority of refugees are Syrians who have fled the Syrian war that started in 2011. The migration journey exposes refugees to increased susceptibility to a wide range of medical issues including non-communicable diseases (NCDs). This study aims to determine the prevalence of NCDs among adult Syrian refugees in Lebanon, with a focus on hypertension, diabetes, cardiovascular diseases (CVD) and cancer. The study also aims to explore factors potentially related to the prevalence figures and understand the medication use associated with these morbidities. Methods This study is a secondary analysis of de-identified data from the “Sijilli Electronic Health Records for Refugees” Database comprising data on 10,082 Syrian refugees from across informal tented settlements located all over Lebanon. A total of 3,255 records of Syrian refugees aged above 18 years old and reporting having at least one condition of the following were included in the analysis: hypertension, diabetes, Cardiovascular diseases or cancer. Pearson’s Chi-square, independent t-test, and multivariate logistic regressions were used for data analysis. Results Hypertension was the most prevalent (10.0%) NCD among refugees, and a higher age was associated with higher NCDs prevalence. A strong linkage has been reported between smoking status and alcohol intake, and increased risk for NCDs. Study findings also revealed that the highest prevalence of hypertension, diabetes and CVDs was observed among refugees originating from Idlib, Aleppo and Homs. An association between adherence to medication and location of diagnosis was noted, with females who were diagnosed before moving to Lebanon being more likely to take corresponding medications compared to those diagnosed in Lebanon, with no difference reported among males. Conclusions Our findings suggest that efforts should be directed towards the employment of innovative low-cost approaches for NCD detection and control among refugees, with a focus on the importance of adherence to medication. Such efforts remain imperative to control the increasing burden of NCDs amongst refugee populations and improve equitable access to NCD services.

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Childhood obesity trends from primary care electronic health records in England between 1994 and 2013: population-based cohort study

Archives of Disease in Childhood ◽

10.1136/archdischild-2014-307151 ◽

2015 ◽

Vol 100 (3) ◽

pp. 214-219 ◽

Cited By ~ 73

Author(s):

Cornelia H M van Jaarsveld ◽

Martin C Gulliford

Keyword(s):

Primary Care ◽

Cohort Study ◽

Electronic Health Records ◽

Age Groups ◽

Overweight And Obesity ◽

Practice Research ◽

Clinical Practice Research Datalink ◽

Health Records ◽

Obesity Trends ◽

Electronic Health

ObjectiveThis study aimed to use primary care electronic health records to evaluate the prevalence of overweight and obesity in 2–15-year-old children in England and compare trends over the last two decades.DesignCohort study of primary care electronic health records.Setting375 general practices in England that contribute to the UK Clinical Practice Research Datalink.PatientsIndividual participants were sampled if they were aged between 2 and 15 years during the period 1994–2013 and had one or more records of body mass index (BMI).Main outcome measurePrevalence of overweight (including obesity) was defined as a BMI equal to or greater than the 85th centile of the 1990 UK reference population.ResultsData were analysed for 370 544 children with 507 483 BMI records. From 1994 to 2003, the odds of overweight and obesity increased by 8.1% per year (95% CI 7.2% to 8.9%) compared with 0.4% (−0.2% to 1.1%) from 2004 to 2013. Trends were similar for boys and girls, but differed by age groups, with prevalence stabilising in 2004 to 2013 in the younger (2–10 year) but not older (11–15 year) age group, where rates continued to increase.ConclusionsPrimary care electronic health records in England may provide a valuable resource for monitoring obesity trends. More than a third of UK children are overweight or obese, but the prevalence of overweight and obesity may have stabilised between 2004 and 2013.

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Non-communicable diseases are key to further narrow gender gap in life expectancy in Shanghai, China

10.21203/rs.2.20284/v4 ◽

2020 ◽

Author(s):

Hanyi Chen ◽

Yi Zhou ◽

Lianghong Sun ◽

Yichen Chen ◽

Xiaobin Qu ◽

...

Keyword(s):

Cardiovascular Diseases ◽

Life Expectancy ◽

Gender Gap ◽

Causes Of Death ◽

Age Groups ◽

International Classification Of Diseases ◽

Communicable Diseases ◽

Plateau Phase ◽

Non Communicable Diseases ◽

Chronic Respiratory Diseases

Abstract Background To address change in gender gap of life expectancy (GGLE) in Shanghai from 1973 to 2018, and to identify the major causes of death and age groups associated with the change overtime.Methods Retrospective demographic analysis with application of Joinpoint regression to evaluate the temporal trend in GGLE. Causes of death were coded in accordance with International Classification of Diseases and mapped with the Global Burden of Disease (GBD) cause list. Life table technique and decomposition method was used to express changes in GGLE.Results Trend of GGLE in Shanghai experienced two phases ie., a decrease from 8.4 to 4.2 years in the descent phase (1973-1999) and a fluctuation between 4.0 and 4.9 years in the plateau phase (1999-2018). The reduced age-specific mortality rates tended to concentrate to a narrower age range, from age 0-9 and above 30 years in the descent phase to age above 55 years in the plateau phase. Gastroesophageal and liver cancer, communicable, chronic respiratory and digestive diseases were once the major contributors to narrow GGLE in the descent phase. While importance should be attached to a widening effect on GGLE by lung cancer, cardiovascular diseases, other neoplasms like colorectal and pancreatic cancer and diabetes in recent plateau phase.Conclusions Non-communicable diseases (NCDs) have made GGLE enter a plateau phase from a descent phase in Shanghai China. Public efforts to reduce excess mortalities for male NCDs, cancers, cardiovascular diseases, chronic respiratory diseases and diabetes in particular and health policies focused on the middle-aged and elderly population might further narrow GGLE and ensure improvement in health and health equity in Shanghai China.

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Non-communicable diseases are key to further narrow gender gap in life expectancy in Shanghai, China

10.21203/rs.2.20284/v1 ◽

2020 ◽

Author(s):

Hanyi Chen ◽

Yi Zhou ◽

Lianghong Sun ◽

Yichen Chen ◽

Xiaobin Qu ◽

...

Keyword(s):

Cardiovascular Diseases ◽

Life Expectancy ◽

Gender Gap ◽

Age Groups ◽

Communicable Diseases ◽

Plateau Phase ◽

Non Communicable Diseases ◽

Chronic Respiratory Diseases ◽

Two Phases ◽

Age Range

Abstract Background To address change in gender gap of life expectancy (GGLE) in Shanghai from 1973 to 2018, and to identify the major causes of death and age groups associated with the change overtime. Methods Retrospective demographic analysis with application of Joinpoint regression to evaluate the temporal trend in GGLE and using life table technique and decomposition method to express changes in GGLE. Results Trend of GGLE in Shanghai experienced two phases ie., a decrease from 8.4 to 4.2 years in the descent phase (1973-1999) and a fluctuation between 4.0 and 4.9 years in the plateau phase (1999-2018). The reduced age-specific mortality rates tended to concentrate to a narrower age range, from age 0-9 and above 30 years in the descent phase to age above 55 years in the plateau phase. Gastroesophageal and liver cancer, communicable, chronic respiratory and digestive diseases were once the major contributors to narrow GGLE in the descent phase. While importance should be attached to a widening effect on GGLE by lung cancer, cardiovascular diseases, other neoplasms like colorectal and pancreatic cancer and diabetes in recent plateau phase. Conclusions Non-communicable diseases (NCDs) have made GGLE enter a plateau phase from a descent phase in Shanghai China. Public efforts to reduce excess mortalities for male NCDs, cancers, cardiovascular diseases, chronic respiratory diseases and diabetes in particular and health policies focused on the middle-aged and elderly population might further narrow GGLE and ensure improvement in health and health equity in Shanghai China.

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Non-communicable diseases are key to further narrow gender gap in life expectancy in Shanghai, China

10.21203/rs.2.20284/v3 ◽

2020 ◽

Author(s):

Hanyi Chen ◽

Yi Zhou ◽

Lianghong Sun ◽

Yichen Chen ◽

Xiaobin Qu ◽

...

Keyword(s):

Cardiovascular Diseases ◽

Life Expectancy ◽

Gender Gap ◽

Causes Of Death ◽

Age Groups ◽

International Classification Of Diseases ◽

Communicable Diseases ◽

Plateau Phase ◽

Non Communicable Diseases ◽

Chronic Respiratory Diseases

Abstract Background: To address change in gender gap of life expectancy (GGLE) in Shanghai from 1973 to 2018, and to identify the major causes of death and age groups associated with the change overtime.Methods: Retrospective demographic analysis with application of Joinpoint regression to evaluate the temporal trend in GGLE. Causes of death were coded in accordance with International Classification of Diseases and mapped with the Global Burden of Disease (GBD) cause list. Life table technique and decomposition method was used to express changes in GGLE.Results: Trend of GGLE in Shanghai experienced two phases ie., a decrease from 8.4 to 4.2 years in the descent phase (1973-1999) and a fluctuation between 4.0 and 4.9 years in the plateau phase (1999-2018). The reduced age-specific mortality rates tended to concentrate to a narrower age range, from age 0-9 and above 30 years in the descent phase to age above 55 years in the plateau phase. Gastroesophageal and liver cancer, communicable, chronic respiratory and digestive diseases were once the major contributors to narrow GGLE in the descent phase. While importance should be attached to a widening effect on GGLE by lung cancer, cardiovascular diseases, other neoplasms like colorectal and pancreatic cancer and diabetes in recent plateau phase.Conclusions: Non-communicable diseases (NCDs) have made GGLE enter a plateau phase from a descent phase in Shanghai China. Public efforts to reduce excess mortalities for male NCDs, cancers, cardiovascular diseases, chronic respiratory diseases and diabetes in particular and health policies focused on the middle-aged and elderly population might further narrow GGLE and ensure improvement in health and health equity in Shanghai China.

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The Adoption Level of Electronic Health Records in Turkish Hospitals and the Relation with Hospital Sizes

10.21203/rs.2.17869/v1 ◽

2019 ◽

Author(s):

Ilker Kose ◽

John Rayner ◽

Suayip Birinci ◽

Mustafa Mahir Ulgu ◽

Ismayil Yilmaz ◽

...

Keyword(s):

Electronic Health Records ◽

Medical Information ◽

Clinical Care ◽

Public Hospitals ◽

Maturity Model ◽

Health Records ◽

Hospital Size ◽

Electronic Health ◽

Adoption Level ◽

Better Than

Abstract Background Considering the benefits of using electronic health records (EHR) for maintaining the overall quality of clinical care, the nationwide adoption of EHR in hospitals has become a policy priority. The electronic medical record maturity model (EMRAM) is one of the most popular survey tools developed by the Healthcare Information and Management Systems Society (HIMSS) that measures the level of adoption for EHR functions in a hospital or a secondary care setting. This study aims to measure the digital capacity of public hospitals in Turkey and criticize the relation between adoption and hospital size. Methods EMRAM surveys were completed by 600 (68.9%) public hospitals of Turkey between 2014 and 2017. The availability and prevalence of medical information systems and EHR functions were measured. The association between hospital size and the availability/prevalence of EHR functions was also calculated.Results We found that 63.1% of all hospitals in Turkey have at least basic EHR functions, and 36% have comprehensive EHR functions, which is better than the results of Korean hospitals of 2017 but still lower than the USA hospitals of 2015 (1)[1]and 2017. Our findings suggest that small hospitals are better than larger hospitals at adopting certain EHR functions. Conclusion Measuring the overall adoption level of EHR functions is an emerging approach and a beneficial tool for the strategic management of countries. This study is the first one covering all public hospitals in a country by using EMRAM. The results are used by MoH of Turkey to disseminate the benefits of EHR functions overall in the country.

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Electronic Health Records Functionalities in Saudi Arabia: Obstacles and Major Challenges

Global Journal of Health Science ◽

10.5539/gjhs.v10n4p50 ◽

2018 ◽

Vol 10 (4) ◽

pp. 50 ◽

Cited By ~ 2

Author(s):

A. Karim Jabali ◽

Mu'taman Jarrar

Keyword(s):

Saudi Arabia ◽

Electronic Health Records ◽

Resistance To Change ◽

Public Hospitals ◽

Current Status ◽

Innovative Technology ◽

Health Records ◽

Large Size ◽

Comprehensive Survey ◽

Electronic Health

BACKGROUND & OBJECTIVES: Despite the innovative technology availability, however, the functionalities of usefulness are limited and not been explored in Saudi Arabian hospitals. This study aims to determine the extent and diffusion of Electronic Health Records (EHR) in public hospitals in Saudi Arabia and to explore the main obstacles, and problems of adopting EHR in these hospitals.METHODS: A comprehensive survey was developed and sent to the medium and large size hospital stakeholders to collect their opinions on the current status of the adoption and usage of EHR. Cluster random sampling has been used. The study has been conducted in the eastern province.RESULTS: Based on the 15 hospitals surveyed in the Eastern Province (EP), Saudi Arabia, a total of seven hospitals (46.6%) had an EHR system and the implementation is running. EHR is mostly used for order entry (51.11%) and char review (41.11%) in the EP in Saudi Arabia with obstacles to be used for decision support, documentation functions, communication tools. Despite the “secured” EHR system, the results shows that security mechanism did not cover all threats.CONCLUSION: The results suggest that more public hospitals are required to adopting more and more EHR and EHR functionalities. A periodic assessment of EHR status should be performed in addition to or part of an encouraging/ enforcing policies that can significantly increase the rate of adoption of EHR systems. Managers and policymakers can benefit from the study by facing obstacles and general challenges of problems like resistance to change from the medical staff in using the information technology, low and weak financing, and train technical supporting staff for adopting EHR.

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Evaluating Electronic Health Records Systems in Jordan Extending EUCS With Self-Efficacy

International Journal of Electronic Government Research ◽

10.4018/ijegr.2020040101 ◽

2020 ◽

Vol 16 (2) ◽

pp. 1-18

Author(s):

Ali Odeh Aljaafreh

Keyword(s):

Electronic Health Records ◽

Self Efficacy ◽

Information Quality ◽

Public Hospitals ◽

System Quality ◽

End User ◽

Ministry Of Health ◽

Health Records ◽

Proposed Model ◽

Electronic Health

This study empirically examines the system satisfaction of employees from the Ministry of Health in Jordan toward the enhancement of the electronic health records (EHR) named HAKEEM. The proposed model has assimilated factors from the enriched end-user computer satisfaction (EUCS) model along with self-efficacy as a new predictor. The participants were 463 respondents distributed in public hospitals through all the country of Jordan. The data were collected by means of a self-administered survey and analyzed using SEM technique. The findings revealed that EUCS is significantly and positively affected by information quality, system quality, and self-efficacy. The study is also looking forward to providing empirical results and applicable recommendations for the Ministry of Health and HAKEEM provider in order to enhance and maximize the benefit of such EHR.

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The Adoption Level of Electronic Health Records in Turkish Hospitals and the Relation with Hospital Sizes

10.21203/rs.2.17869/v2 ◽

2020 ◽

Author(s):

Ilker Kose ◽

John Rayner ◽

Suayip Birinci ◽

Mustafa Mahir Ulgu ◽

Ismayil Yilmaz ◽

...

Keyword(s):

Electronic Health Records ◽

Clinical Care ◽

Public Hospitals ◽

Health Records ◽

Bottom Up ◽

Hospital Size ◽

The Usa ◽

Electronic Health ◽

Adoption Level ◽

Better Than

Abstract Background: Considering the benefits of using electronic health records (EHR) for maintaining the overall quality of clinical care, the nationwide adoption of EHR in hospitals has become a policy priority. The electronic medical record maturity model (EMRAM) is one of the most popular survey tools developed by the Healthcare Information and Management Systems Society (HIMSS) that measures the level of adoption for EHR functions in a hospital or a secondary care setting. Turkey has accomplished many standardizations and infrastructural studies in the health IT domain as a part of the first phase of the Health Transformation Program between 2003 and 2017. The Turkish MoH applied a bottom-up approach to adopting EHR in public hospitals, as the USA did. This study aims to measure the EHR adoption level of public hospitals in Turkey and criticize the relation between adoption and hospital size. Methods: EMRAM surveys were completed by 600 (68.9%) public hospitals of Turkey between 2014 and 2017. The availability and prevalence of medical information systems and EHR functions were measured. The association between hospital size and the availability/prevalence of EHR functions was also calculated. Results: We found that 63.1% of all hospitals in Turkey have at least basic EHR functions, and 36% have comprehensive EHR functions, which is better than the results of Korean hospitals of 2017 but still lower than the USA hospitals of 2015 and 2017. Our findings suggest that small hospitals are better than larger hospitals at adopting certain EHR functions. Conclusion: Measuring the overall adoption level of EHR functions is an emerging approach and a beneficial tool for the strategic management of countries. This study is the first one covering all public hospitals in a country by using EMRAM. It can be suggested that using a bottom-up approach as applied by the USA on adopting EHR in public hospital gives successful results also in Turkey. The results are used by MoH of Turkey to disseminate the benefits of EHR functions overall in the country.

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