scholarly journals A review of the inclusion of equity stratifiers for the measurement of health inequalities within health and social care data collections in Ireland

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christopher Carroll ◽  
Katie Evans ◽  
Khalifa Elmusharaf ◽  
Patrick O’Donnell ◽  
Anne Dee ◽  
...  
Keyword(s):  
Data Collection ◽  
Health Inequalities ◽  
Social Relations ◽  
Social Care ◽  
Data Dictionary ◽  
Regional Data ◽  
National Surveys ◽  
Concept Of Health ◽  
Health And Social Care ◽  
Data Collections

Abstract Background Health equity differs from the concept of health inequality by taking into consideration the fairness of an inequality. Inequities may be culturally specific, based on social relations within a society. Measuring these inequities often requires grouping individuals. These groupings can be termed equity stratifiers. The most common groupings affected by health inequalities are summarised by the acronym PROGRESS (Place of residence, Race, Occupation, Gender, Religion, Education, Socioeconomic status, Social capital). The aim of this review was to examine the use of equity stratifiers in routinely collected health and social care data collections in Ireland. Methods One hundred and twenty data collections were identified from the Health Information and Quality Authority (HIQA) document, “Catalogue of national health and social care data collections: Version 3.0”. Managers of all the data collections included were contacted and a data dictionary was requested where one was not available via the HIQA website. Each of the data dictionaries available was reviewed to identify the equity stratifiers recorded. Results Eighty-three of the 120 data collections were considered eligible to be included for review. Twenty-nine data dictionaries were made available. There was neither a data dictionary available nor a response to our query from data collection managers for twenty-three (27.7%) of the data collections eligible for inclusion. Data dictionaries were from national data collections, regional data collections and national surveys. All data dictionaries contained at least one of the PROGRESS equity stratifiers. National surveys included more equity stratifiers compared with national and regional data collections. Definitions used for recording social groups for the stratifiers examined lacked consistency. Conclusions While there has been much discussion on tackling health inequalities in Ireland in recent years, health and social care data collections do not always record the social groupings that are most commonly affected. In order to address this, it is necessary to consider which equity stratifiers should be used for the Irish population and, subsequently, for agreed stratifiers to be incorporated into routine health data collection. These are lessons that can be shared internationally as other countries begin to address deficits in their use of equity stratifiers.

scholarly journals A review of the inclusion of equity stratifiers for the measurement of health inequalities within health and social care data collections in Ireland

2020 ◽  
Author(s):  
Christopher Carroll ◽  
Katie Evans ◽  
Khalifa Elmusharaf ◽  
Patrick O'Donnell ◽  
Anne Dee ◽  
...  
Keyword(s):  
Data Collection ◽  
Health Inequalities ◽  
Social Relations ◽  
Social Care ◽  
Data Dictionary ◽  
Regional Data ◽  
National Surveys ◽  
Concept Of Health ◽  
Health And Social Care ◽  
Data Collections

Abstract Background Health equity differs from the concept of health inequality by taking into consideration the fairness of an inequality. Inequities may be culturally specific, based on social relations within a society. Measuring these inequities often requires grouping individuals. These groupings can be termed equity stratifiers. The most common groupings affected by health inequalities are summarised by the acronym PROGRESS. The aim of this review was to examine the use of equity stratifiers in routinely collected health and social care data collections in Ireland. Methods One hundred and twenty data collections were identified from the Health Information and Quality Authority (HIQA) document, “Catalogue of national health and social care data collections: Version 3.0”. Managers of all the data collections included were contacted and a data dictionary was requested where one was not available via the HIQA website. Each of the data dictionaries available was reviewed to identify the equity stratifiers recorded. Results Eighty-three of the 120 data collections were considered eligible to be included for review. Twenty-nine data dictionaries were made available. There was neither a data dictionary available nor a response to our query from data collection managers for twenty-three (27.7%) of the data collections eligible for inclusion. Data dictionaries were from national data collections, regional data collections and national surveys. All data dictionaries contained at least one of the PROGRESS equity stratifiers. National surveys included more equity stratifiers compared with national and regional data collections. There was a lack of consistency in the definitions used for recording social groups for the stratifiers examined. Conclusions While there has been much discussion on tackling health inequalities in Ireland in recent years, health and social care data collections do not always record the social groupings that are most commonly affected. In order to address this, it is necessary to consider which equity stratifiers should be used for the Irish population and, subsequently, for agreed standardised statifiers to be incorporated into routine health data collection. These are lessons that can be shared internationally as other countries begin to address deficits in the use of equity stratifiers.

scholarly journals Ethnicity recording in health and social care data collections in Ireland: where and how is it measured and what is it used for?

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ailish Hannigan ◽  
Nazmy Villarroel ◽  
Maria Roura ◽  
Joseph LeMaster ◽  
Alphonse Basogomba ◽  
...  
Keyword(s):  
Data Collection ◽  
Social Care ◽  
Ethnic Origin ◽  
The European Union ◽  
Key Informants ◽  
Targeted Interventions ◽  
Health And Social Care ◽  
Legal Duty ◽  
Data Collections ◽  
Ethnicity Data

Abstract Background In the European Union (EU), discrimination based on racial and ethnic origin is prohibited under the Racial Equality Directive. Ireland is one of only three EU countries where a legal duty of equality data collection is placed on public bodies. It provides an important context in which to study ethnic equality monitoring; however no systematic mapping of where it occurs in health information systems has been carried out. The aim of this study is to identify all existing national health and social care data collections with information on ethnicity and to explore how this data has been collected and used. Methods An electronic search of a national catalogue of health and social care data collections (N = 97) was carried out to identify any collections which contained information on ethnicity. Data dictionaries were searched and key informants contacted. For each of the data collections that collected information on ethnicity, data was extracted on the ethnic categories used and how this data is collected; the completeness of ethnicity recording; and other measures related to ethnicity in the data collection. Relevant outputs for these data collections, related to ethnicity, were identified through key informants and electronic searches. Results Of the 97 data collections, 14 (14%) collected information on ethnic or cultural background. Country of birth was collected by 10 of these 14 data collections. Most used the ethnic categories in the Census and recommended that ethnicity should be self-identified and not assigned. Reported rates of identification were generally high (≥90%). Data collections which recorded ethnicity tended to be focused on potentially high-risk populations with no routine recording in primary care. There were some examples of where ethnic equality monitoring had informed targeted interventions e.g. vaccination awareness initiatives or cultural training for healthcare staff. Conclusions Despite strong policy and legal imperatives, there is limited data collection of ethnicity in health and social care data collections in Ireland. While there are some examples of where differences by ethnicity have been identified and acted upon, a more coordinated and comprehensive approach to the collection, quality and utilization of ethnicity data is needed to promote health equity.

scholarly journals Best Paper Selection

2020 ◽  
Vol 29 (01) ◽  
pp. 091-092
Keyword(s):  
Respiratory Diseases ◽  
Social Care ◽  
Healthcare Providers ◽  
Health Department ◽  
Mixed Methods Study ◽  
Local Health ◽  
Health Records ◽  
Health And Social Care ◽  
Perceived Workload ◽  
Data Collections

Hosseini M , Faiola A, Jones J, Vreeman DJ, Wu H, Dixon BE. Impact of document consolidation on healthcare providers’ perceived workload and information reconciliation tasks: a mixed methods study. J Am Med Inform Assoc 2019;26(2):134-42 https://academic.oup.com/jamia/article/26/2/134/5253582 Yeung T. Local health department adoption of electronic health records and health information exchanges and its impact on population health. Int J Med Inform 2019;128:1-6 https://www.sciencedirect.com/science/article/abs/pii/S1386505618310426?via%3Dihub Souza J, Santos JV, Canedo VB, Betanzos A, Alves D, Freitas A. Importance of coding co-morbidities for APR-DRG assignment: Focus on cardiovascular and respiratory diseases. Health Inf Manag 2020;49(1):47-57 https://journals.sagepub.com/doi/full/10.1177/1833358319840575?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed Hannigan A, Villarroel N, Roura M, LeMaster J, Basogomba A, Bradley C, MacFarlane A. Ethnicity recording in health and social care data collections in Ireland: where and how is it measured and what is it used for?. Int J Equity Health 2019;19(1):2 https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-019-1107-y

The Role of Health Inequalities and Assessing Impacts on Population Health

2015 ◽  
Vol 5 (1) ◽  
pp. 68-74
Author(s):  
Shahid Muhammad
Keyword(s):  
Population Health ◽  
Health Inequalities ◽  
Social Care ◽  
Health In All Policies ◽  
Missed Opportunities ◽  
Department Of Health ◽  
Health And Social Care ◽  
Average Health ◽  
Missed Opportunity

In ‘today's' world, technology advances are pacing and surrounding all areas of health and social care. Whilst the ‘age of technology' has its certainties, health professionals are still identifying missed opportunities in diagnosis for specific diseases and this has its own burden and impact on over budgeting and healthcare. There now seems to be charade in allocating the appropriate funds in those sectors that require more man-power than technology. In turn health has now become more about through-put then compassion (Barnett et al. 2012; Department of Health 2012; Luxford and Sutton 2014; Muhammad et al. 2015). Here, the author briefly explores the role of average health status – Health Inequalities (or Panayotov Matrix) for Assessing Impacts on Population Health and Health in All Policies (HiAP) in the ‘age of technology' and missed opportunity in diagnoses, providing a Chronic Kidney Disease (CKD) example.

scholarly journals Opening up the NHS to market

2016 ◽  
Vol 15 (3) ◽  
pp. 288-303 ◽  
Author(s):  
Gavin Brookes ◽  
Kevin Harvey
Keyword(s):  
Critical Discourse Analysis ◽  
Social Relations ◽  
Service Provision ◽  
Social Care ◽  
Corporate Identity ◽  
Critical Discourse ◽  
Care Provision ◽  
Textual Evidence ◽  
Health And Social Care ◽  
Opening Up

Abstract Since its implementation, the British Government’s controversial 2013 Health and Social Care Act has had far-reaching effects on health care provision in England, not least the creation of 212 regional practitioner-led clinical commissioning groups (CCGs) which are now responsible for much of the service provision across the country. Taking as an example the website of one of these new commissioning groups, this study shows that multimodal critical discourse analysis (MCDA) can reveal how health and social care matters are being increasingly framed within a corporate and neoliberal set of ideas, values, identities and social relations. Despite government assurances that the Act preserves the (non-commercial) founding values of the NHS, our MCDA provides textual evidence of the influence of neoliberal and commercial discourses operating across this particular website, which appear to be just as much about promoting an appealing corporate identity as responding to the practical, day-to-day concerns of patients.

scholarly journals Using administrative health data for palliative and end of life care research in Ireland: potential and challenges

2021 ◽  
Vol 4 ◽  
pp. 17
Author(s):  
Maria Kelly ◽  
Katie M O'Brien ◽  
Ailish Hannigan
Keyword(s):  
Palliative Care ◽  
Health System ◽  
End Of Life ◽  
Data Protection ◽  
End Of Life Care ◽  
Social Care ◽  
Data Access ◽  
Life Care ◽  
Health And Social Care ◽  
Data Collections

Background: This study aims to examine the potential of currently available administrative health and social care data for palliative and end-of-life care (PEoLC) research in Ireland. Objectives include to i) identify data sources for PEoLC research ii) describe the challenges and opportunities of using these and iii) evaluate the impact of recent health system reforms and changes to data protection laws. Methods: The 2017 Health Information and Quality Authority catalogue of health and social care datasets was cross-referenced with a recognised list of diseases with associated palliative care needs. Criteria to assess the datasets included population coverage, data collected, data dictionary and data model availability, and mechanisms for data access. Results: Nine datasets with potential for PEoLC research were identified, including death certificate data, hospital episode data, pharmacy claims data,  one national survey, four disease registries (cancer, cystic fibrosis, motor neurone and interstitial lung disease) and a national renal transplant registry.  The ad hoc development of the health system in Ireland has resulted in i) a fragmented information infrastructure resulting in gaps in data collections particularly in the primary and community care sector where much palliative care is delivered, ii) ill-defined data governance arrangements across service providers, many of whom are not part of the publically funded health service and iii) systemic and temporal issues that affect data quality. Initiatives to improve data collections include introduction of i) patient unique identifiers, ii) health entity identifiers and iii) integration of the Eircode postcodes. Recently enacted general data protection and health research regulations will clarify legal and ethical requirements for data use. Conclusions: Ongoing reform initiatives and recent changes to data privacy laws combined with detailed knowledge of the datasets, appropriate permissions, and good study design will facilitate future use of administrative health and social care data for PEoLC research in Ireland.

Healthcare public health

2020 ◽  
pp. 1-7
Author(s):  
Martin Gulliford ◽  
Edmund Jessop
Keyword(s):  
Public Health ◽  
Health Services ◽  
Health Inequalities ◽  
Subject Matter ◽  
Social Care ◽  
Health It ◽  
Art And Science ◽  
Health And Social Care ◽  
Health Related

Healthcare public health can be defined as ‘the art and science of preventing disease, prolonging life, and promoting health through the organization and delivery of population-wide health services’. This book provides an introduction to the methods and subject matter of healthcare public health. It aims to enable future students, researchers, and practitioners to contribute to the goals of designing effective, efficient, and equitable systems of health and social care; facilitating access and meeting the needs of all individuals and groups; maximizing the population benefits of healthcare including preventing disease; improving health-related outcomes; and reducing health inequalities.

scholarly journals Electronic data management for vaccine trials in low resource settings: Upgrades, scalability and impact of ODK

2021 ◽  
Author(s):  
Michael Marks ◽  
Sham Lal ◽  
Hannah Brindle ◽  
Pierre-Stéphane Gsell ◽  
Matthew MacGregor ◽  
...  
Keyword(s):  
Data Collection ◽  
Clinical Research ◽  
Data Management ◽  
Open Source ◽  
Social Care ◽  
World Health ◽  
Electronic Data ◽  
Diverse Range ◽  
Department Of Health ◽  
Health And Social Care

ABSTRACTBackgroundODK provides software and standards that are popular solutions for off-grid electronic data collection and has substantial code overlap and interoperability with a number of related software products including CommCare, Enketo, Ona, SurveyCTO and KoBoToolbox. In combination with the use of statistical analysis software such as R, these tools provide fully open-source options for off-grid use in public health data collection, management, analysis and reporting. During the 2018-2020 Ebola epidemic in the North Kivu & Ituri regions of Democratic Republic of Congo, we leveraged ODK and other tools to support the DRC Ministère de la Santé RDC and World Health Organization in their efforts to administer an experimental vaccine (VSV-Zebov-GP) as part of their strategy to control the transmission of infection.MethodNew functions were developed to facilitate the use of ODK, Enketo and R in large scale data collection, aggregation, monitoring and near-real-time analysis during clinical research in health emergencies. We present open-source enhancements to ODK that include a built-in audit-trail, a framework and companion app for biometric registration of ISO/IEC 19794-2 fingerprint templates, enhanced performance features, better scalability for studies featuring millions of data form submissions, increased options for parallelization of research projects, and pipelines for automated management and analysis of data. We also developed novel encryption protocols for enhanced web-form security in Enketo.ResultsAgainst the backdrop of a complex and challenging epidemic response, our enhanced platform of open tools was used to collect and manage data from more than 280,000 eligible study participants who received VSV-Zebov-GP under informed consent. These data were used to determine whether the VSV-Zebov-GP was safe and effective and to guide daily field operations.ConclusionsWe present open-source developments that make electronic data management during clinical research and health emergencies more viable and robust. These developments will also enhance and expand the functionality of a diverse range of data collection platforms (Ona, KoBoToolbox etc.) that are based on the ODK software and standards.FundingThis research is funded by the Department of Health and Social Care using UK Aid funding and is managed by the NIHR (PR-OD-1017-20001). The views expressed in this publication are those of the authors and not necessarily those of the Department of Health and Social Care.

scholarly journals Specialist nursing support for unpaid carers of people with dementia: a mixed-methods feasibility study

2019 ◽  
Vol 7 (12) ◽  
pp. 1-198 ◽  
Author(s):  
Kate Gridley ◽  
Fiona Aspinal ◽  
Gillian Parker ◽  
Helen Weatherly ◽  
Rita Faria ◽  
...  
Keyword(s):  
Data Collection ◽  
Usual Care ◽  
Social Care ◽  
Cross Sectional ◽  
Data Set ◽  
Nursing Support ◽  
Care Services ◽  
People With Dementia ◽  
Health And Social Care ◽  
Collection Methods

Background Unpaid carers are the mainstay of support for people with dementia. Admiral Nursing (AN) is the only specialist nursing service that specifically focuses on supporting such carers, but evidence of its effectiveness, costs and relationships with other health and social care services is limited. This project aimed to address this gap and explore the feasibility of a full-scale formal evaluation. Objectives To explore the relationships between characteristics of carers and people with dementia, service type and input and outcomes; to develop and test data collection methods for subsequent economic evaluation; to explore the effect of AN on outcomes and costs, compared with usual care; to explore the perceived system-wide impact of specialist support for carers of people with dementia, compared with usual care; and to implement new data collection methods in AN, which could also be used by other services, to facilitate evaluation. Design A mixed-methods study, using secondary analysis of an administrative data set, and primary (cross-sectional) quantitative and qualitative data collection. Setting Qualitative research with carers in four areas of England; a survey of carers in 32 local authority areas (16 with and 16 without AN); and qualitative interviews with professionals in four areas. Participants Thirty-five carers of people with dementia and 20 professionals were interviewed qualitatively; 346 carers completed in-scope questionnaires (46% through AN services and 54% from matched non-AN areas). Interventions Specialist nursing support for carers of people with dementia (with AN as an exemplar) compared with usual care. Main outcome measures The Adult Social Care Outcomes Toolkit for Carers; the EuroQol-5 Dimensions, five-level version; and the Caregiver Self-Efficacy for Managing Dementia Scale. Data sources Dementia UK’s AN administrative data set. Results Admiral Nurses are successfully targeting the most complex cases. They work predominantly with older carers who have the main responsibility for the person with dementia, who are heavily involved in caring activity and who may be at risk. Three outcome areas that are important to carers of people with dementia and are potentially affected by receiving support are (1) carer self-efficacy, (2) carer quality of life (3) and carer mental and physical health. The carers in the survey receiving support from AN were older, were more heavily involved in caring and had poorer outcomes than carers not in receipt of such support. When these differences were controlled for, carers supported by AN had better outcomes, although the differences did not reach statistical significance. Health and social care costs were similar in both groups. The perceived system-wide impact of services, such as AN, is not well understood by professional stakeholders. Limitations Challenges were experienced in identifying similar carers in areas with or without an AN service and in the cross-sectional nature of the work. Conclusions Specialist nursing support to carers of people with dementia may enable them to continue providing care to the end or very close to the end of the dementia journey. The outcomes for such carers may be no different from, or even slightly better than, those of similar carers without this support, although the costs to health and social care services are the same in each case. Future work Future research could investigate the impact of specialist support for carers on admission to long-term care. There is also a need for more work to encourage routine use of the selected outcome measures in dementia service delivery. Funding The National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals Welfare Technologies in Care Work

2019 ◽  
Vol 9 (S5) ◽  
Author(s):  
Annette Kamp ◽  
Aud Obstfelder ◽  
Katarina Andersson
Keyword(s):  
Social Relations ◽  
Social Care ◽  
User Involvement ◽  
Working Life ◽  
Care Work ◽  
Reform Initiatives ◽  
Occupational Groups ◽  
Health And Social Care ◽  
Work Tasks

Welfare technologies have within the last few years become a new mantra for reforming the Nordic public health and social care, and are increasingly making their impact on working life of care professionals.Welfare technologies – a term exclusively used in a Nordic context – is a broad and loosely defined concept that covers a wide array of technologies such as tele-care solutions, automatic toilets, eating robots, GPS-trackers, and many others. They are envisioned as leading to a new and smarter form of retrenchment, promising better quality, empowerment of clients, and work that is smarter and more qualified (e.g., Danish government et al. 2013). Together with other reform initiatives like coproduction, rehabili- tation, and user-involvement, welfare technologies aim at enabling a change in the role of the clients/patients, stressing their resourcefulness and potentials and encouraging to self-responsibilization and self-care (Rose 1998; Triantafillou 2017).This implies a fundamental reorganization of care work, a transformation of what care and care work is about, and consequently of meaning and identity in work (see, e.g., Barnes & Cotterell 2012; Järvinen 2012; Kirkegaard & Andersen 2018; Meldgaard Hansen & Kamp 2018). More concretely, we may expect changes in work tasks, social relations and forms of cooperation between occupational groups, and new relations to clients/patients and their relatives. This may not only imply new challenges and strains in work but may also present new possibilities for employees to engage creatively in shaping work in ways that makes care work more meaningful and sustainable. (...)

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