Abstract MP49: Application Of A Novel Assessment Of County-level Cardiovascular Health Profile And Its Association With County-level Disease Rates

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Neil P Rowen ◽  
Daniel Kim ◽  
Hannah P Rayala ◽  
Andrew H Reiter ◽  
Wayne D Rosamond
Keyword(s):  
Hospital Discharge ◽  
Cardiovascular Health ◽  
Circulatory System ◽  
Coastal Region ◽  
Blood Cholesterol ◽  
County Level ◽  
Individual Level ◽  
Discharge Rates ◽  
Novel Approach ◽  
Level Hospital

Background: The AHA’s definition of cardiovascular health (CVH) is based on seven metrics known as Life’s Simple 7 (LS7): smoking, diet, obesity, physical inactivity, high blood cholesterol, high blood pressure, and diabetes. Although used to evaluate CVH at the national and individual level, its use as a local county-level measure of CVH has not yet been studied. Our objective was to create a modification of LS7 using publicly available data to estimate county-level CVH and to determine its association with CVH outcomes in all 100 counties of North Carolina (NC). Methods and Results: Using data on all the LS7 metrics collected by the CDC, USDA, BRFSS, and Community Health Assessments, we created a Modified LS7 scoring system, calculated scores for all 100 counties in NC, and created a regression model that predicts county-level hospital discharge rates for diseases and disorders of the circulatory system (Figure 1). Modified LS7 scores ranged from 60.8 to 80.6 (median = 73.1, SD = 3.9). Hospital discharge rates per 100,000 population ranged from 753.4 to 2223.4 (median = 1345.6, SD = 328.7). We found a negative correlation (R-squared = 0.610) between Modified LS7 scores and county-level hospital discharge rates. Counties in the mountain and piedmont regions had significantly higher mean Modified LS7 scores (74.3, 95% CI: 73.5-75.2; 73.9, 95% CI: 72.8-75.0) and lower mean discharge rates (1167.1, 95% CI: 1074.7-1259.5; 1273.9, 95% CI: 1181.4-1366.2) than counties in the coastal plains region (70.7, 95% CI: 69.4-72.0; 1612.3, 95% CI: 1518.5-1706.1). Studentized residuals and leverage points were used to identify five low performing counties and two high performing counties of interest for further analyses. Conclusions: The coastal region of NC was found to have significantly higher CVH risk and poorer CVH outcomes compared to the piedmont and mountain regions. The Modified LS7 model provides a novel approach to examine county-level variation in CVH that had previously only been reported at the national, state or individual level.

scholarly journals Food Environments and Hepatocellular Carcinoma Incidence

2021 ◽  
Vol 18 (11) ◽  
pp. 5740
Author(s):  
Mimi Ton ◽  
Michael J. Widener ◽  
Peter James ◽  
Trang VoPham
Keyword(s):  
Hepatocellular Carcinoma ◽  
Food Environment ◽  
Variance Estimation ◽  
Cancer Registries ◽  
County Level ◽  
Individual Level ◽  
Retail Food Environment ◽  
Food Retailers ◽  
Environment Index ◽  
Rate Ratios

Research into the potential impact of the food environment on liver cancer incidence has been limited, though there is evidence showing that specific foods and nutrients may be potential risk or preventive factors. Data on hepatocellular carcinoma (HCC) cases were obtained from the Surveillance, Epidemiology, and End Results (SEER) cancer registries. The county-level food environment was assessed using the Modified Retail Food Environment Index (mRFEI), a continuous score that measures the number of healthy and less healthy food retailers within counties. Poisson regression with robust variance estimation was used to calculate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for the association between mRFEI scores and HCC risk, adjusting for individual- and county-level factors. The county-level food environment was not associated with HCC risk after adjustment for individual-level age at diagnosis, sex, race/ethnicity, year, and SEER registry and county-level measures for health conditions, lifestyle factors, and socioeconomic status (adjusted IRR: 0.99, 95% CI: 0.96, 1.01). The county-level food environment, measured using mRFEI scores, was not associated with HCC risk.

Information Gained From Linking SEER Cancer Registry Data to State-Level Hospital Discharge Abstracts

Medical Care ◽  
2000 ◽  
Vol 38 (11) ◽  
pp. 1131-1140 ◽  
Author(s):  
John M. Brooks ◽  
Elizabeth Chrischilles ◽  
Shane Scott ◽  
Jane Ritho ◽  
Shari Chen-Hardee
Keyword(s):  
Hospital Discharge ◽  
Cancer Registry ◽  
State Level ◽  
Registry Data ◽  
Cancer Registry Data ◽  
Hospital Discharge Abstracts ◽  
Level Hospital

scholarly journals Hospital discharge rates for suspected acute coronary syndromes between 1990 and 2000: population based analysis

BMJ ◽  
2004 ◽  
Vol 328 (7453) ◽  
pp. 1413-1414 ◽  
Author(s):  
N F Murphy ◽  
K MacIntyre ◽  
S Capewell ◽  
S Stewart ◽  
J Pell ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Acute Coronary Syndromes ◽  
Population Based ◽  
Discharge Rates ◽  
Coronary Syndromes

SmartWoW – constructing a tool for knowledge work performance analysis

2015 ◽  
Vol 64 (4) ◽  
pp. 479-498 ◽  
Author(s):  
Miikka Palvalin ◽  
Maiju Vuolle ◽  
Aki Jääskeläinen ◽  
Harri Laihonen ◽  
Antti Lönnqvist
Keyword(s):  
Work Performance ◽  
Knowledge Work ◽  
Well Being ◽  
Management Tool ◽  
Research Approach ◽  
Work Practices ◽  
Content Type ◽  
Individual Level ◽  
New Ways Of Working ◽  
Novel Approach

Purpose – New Ways of Working (NewWoW) refers to a novel approach for improving the performance of knowledge work. The purpose of this paper is to seek innovative solutions concerning facilities, information technology tools and work practices in order to be able to “work smarter, not harder.” In order to develop work practices toward the NewWoW mode there is a need for an analytical management tool that would help assess the status of the organization’s current work practices and demonstrate the impacts of development initiatives. This paper introduces such a tool. Design/methodology/approach – Constructive research approach was chosen to guide the development of the Smart ways of working (SmartWoW) tool. The tool was designed on the basis of previous knowledge work performance literature as well as on interviews in two knowledge-intensive organizations. The usefulness of the tool was verified by applying it in four organizations. Findings – SmartWoW is a compact questionnaire tool for analyzing and measuring knowledge work at the individual level. The questionnaire consists of four areas: work environment, personal work practices, well-being at work and productivity. As SmartWoW is a standardized tool its results are comparable between organizations. Research limitations/implications – SmartWoW was designed a pragmatic managerial tool. It is considered possible that it can be valuable as a research instrument as well but the current limited amount of collected data does not yet facilitate determining its usefulness from that perspective. Originality/value – This paper makes a contribution to the existing literature on knowledge work measurement and management by introducing an analytical tool which takes into account the NewWoW perspective.

Transitions in “Privatized” Prison Health Systems: Emergency Department Visits and Hospitalizations Among Incarcerated People in Florida, 2011–2018

2021 ◽  
pp. e1-e4
Author(s):  
Jessica L. Adler ◽  
Weiwei Chen ◽  
Timothy F. Page
Keyword(s):  
Public Health ◽  
Health Care ◽  
Emergency Department ◽  
Hospital Discharge ◽  
Emergency Department Visits ◽  
Care Utilization ◽  
Discharge Data ◽  
Prison Health ◽  
Discharge Rates ◽  
Care Problems

Objectives. To examine rates of emergency department (ED) visits and hospitalizations among incarcerated people in Florida during a period when health care management in the state’s prisons underwent transitions. Methods. We used Florida ED visit and hospital discharge data (2011–2018) to depict the trend in ED visit and hospital discharge rates among incarcerated people. We proxied incarcerated people using individuals admitted from and discharged or transferred to a court or law enforcement agency. We fitted a regression with year indicators to examine the significance of yearly changes. Results. Among incarcerated people in Florida, ED visit rates quadrupled, and hospitalization rates doubled, between 2015 and 2018, a period when no similar trends were evident in the nonincarcerated population. Public Health Implications. Increasing the amount and flexibility of payments to contractors overseeing prison health services may foster higher rates of hospital utilization among incarcerated people and higher costs, without addressing major quality of care problems. Hospitals and government agencies should transparently report on health care utilization and outcomes among incarcerated people to ensure better oversight of services for a highly vulnerable population. (Am J Public Health. Published online ahead of print March 18, 2021: e1–e4. https://doi.org/10.2105/AJPH.2020.305988 )

scholarly journals A Novel Use of Honey’s Aggregation Approach to the Analysis of Repertory Grids

Field Methods ◽  
2018 ◽  
Vol 31 (2) ◽  
pp. 150-166 ◽  
Author(s):  
Céline Rojon ◽  
Almuth McDowall ◽  
Mark N. K. Saunders
Keyword(s):  
Implicit Theories ◽  
Personal Construct ◽  
Workplace Performance ◽  
Individual Level ◽  
Repertory Grids ◽  
Novel Approach ◽  
Aggregation Processes ◽  
Grid Technique ◽  
Data Granularity ◽  
Constructivist Epistemology

This article examines and appraises a novel approach for generating shared group constructs through aggregative analysis: the application of Honey’s aggregation procedure to repertory grid technique (RGT) data. Revisiting personal construct theory’s underlying premises and adopting a social constructivist epistemology, we argue that, while “implicit theories” of the world, elicited via RGT, are unique to individuals, the constructs on which they are founded may be shared collectively. Drawing on a study of workplace performance, we outline a protocol for this novel use of Honey’s approach, demonstrating how it can be utilized to generate shared constructs inductively to facilitate theory building. We argue that, unlike other grid aggregation processes, the approach does not compromise data granularity, offering a useful augmentation to traditional idiographic approaches examining individual-level constructs only. This approach appears especially suited to addressing complex and implicit topics, where individuals struggle to convey thoughts and ideas.

Hospital Use Patterns for Children in the United States, 1983 and 1984

PEDIATRICS ◽  
1987 ◽  
Vol 80 (4) ◽  
pp. 481-490 ◽  
Author(s):  
Lola Jean Kozak ◽  
Catherine Norton ◽  
Margaret McManus ◽  
Eileen McCarthy
Keyword(s):  
Health Status ◽  
Hospital Discharge ◽  
Discharge Rate ◽  
The United States ◽  
National Hospital Discharge Survey ◽  
Children's Hospital ◽  
Use Patterns ◽  
Discharge Rates ◽  
Children’S Hospital ◽  
Hospital Use

The hospital discharge rate of children less than 15 years of age in the United States declined 12% from 1983 to 1984. This was the first time in the 20-year history of the National Hospital Discharge Survey that there was a statistically significant decrease in children's hospital discharge rates in a 1-year period. The change occurred during a period when prospective hospital payment systems were introduced and when prepaid group health plans and alternative systems of providing health care were expanding. The unprecedented decrease in children's hospital use was evaluated using data from the National Hospital Discharge Survey. This is a continuous survey in which data from a national sample of medical records of discharged patients are collected. Children's hospital use rates were reviewed by age, sex, region, and expected principal source of payment. Significant decreases in discharge rates were found for the age group 1 to 4 years and for all children with private insurance. The patterns and changes in hospital use by diagnostic category were also investigated. The major finding was a 19% decrease in children's discharge rate for diseases of the respiratory system. Mortality statistics and data from the National Health Interview Survey were evaluated for indications of changes in children's health status or use of physician services accompanying the decline in hospital use. Although there were fewer deaths due to respiratory diseases for children less than 5 years of age in 1984 than in 1983, most measures of health status were unchanged. The only significant change in physician use was a decrease in the percentage of acute conditions that were medically attended, also among children less than 5 years of age. It is important to continue monitoring children's hospital use patterns, as well as their health status and use of alternative health services, to further assess the impact of changes in the organization and financing of health services.

Model Estimates of Hospitalization Discharge Rates for Norovirus Gastroenteritis in Europe, 2004-2015

2020 ◽  
Author(s):  
Elsa Negro Calduch ◽  
Tom Cattaert ◽  
Thomas Verstraeten
Keyword(s):  
Hospital Discharge ◽  
Acute Gastroenteritis ◽  
Patient Discharge ◽  
Trade Association ◽  
Hospital Discharges ◽  
European Free Trade Association ◽  
Hospitalization Rates ◽  
Discharge Rates ◽  
Norovirus Gastroenteritis ◽  
Modelling Methods

Abstract Background: Norovirus is an important cause of acute gastroenteritis globally. However, norovirus is rarely laboratory confirmed or recorded explicitly as a cause of hospitalization. In recent years, there has been an interest in using medical databases and indirect modelling methods to estimate the incidence of norovirus gastroenteritis. The objective of this study was to estimate the incidence of hospitalizations for norovirus gastroenteritis in Europe (2004- 2015) using nationwide in-patient discharge records from different European countries.Methods: National hospital discharge registers in all 28 European Union countries (at that time) and all 4 European Free Trade Association countries were contacted and invited to participate in the study. Discharges with ICD9/ICD10 codes for acute gastroenteritis (AGE) as first-listed (principal) diagnosis were extracted to assess hospitalization rates for AGE and norovirus gastroenteritis (NGE), overall, by age group, country, month, and seasonal year. To estimate NGE hospital discharge rates, a statistical model, based on the temporal patterns of occurrence of AGE, was used. Results: Data were available from 15 countries, representing 68% of the total population in Europe. Only 24.4% of all AGE discharges were coded as cause-specified. We estimated that between 2004 and 2015, the overall rate of NGE hospital discharges in Europe was 3.9 per 10,000 person-years, ranging from 1.2 (Portugal) to 10.7 (Lithuania). Norovirus was predicted to be responsible for 17% of all AGE hospital discharges in Europe in this period. Norovirus affects individuals of all ages, but NGE discharge rates were highest in children <5 years (24.8 per 10,000 person-years), and adults aged ≥80 years (10.7 per 10,000 person-years). Conclusion: We estimated that 1 in 400 hospitalizations in Europe can be attributed to Norovirus. In the absence of routine norovirus testing and recording in hospital settings, modelling methods are useful resources to estimate the incidence of norovirus gastroenteritis.

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