Northwest Portland Area Indian Health Board

Transcription

1 Using Electronically Archived Medical Information for Public Health Analysis of American Indian/Alaska Native Communicable Disease Diagnoses from the Indian Health Service National Data Warehouse Tracking American Indian/Alaska Native (AI/AN) Health No system for aggregate data State/local health jurisdiction (LHJ) data difficult to obtain Misclassification in LHJ Indian Health Service (IHS) National Data Warehouse () Repository of clinical data Pulled from IHS/Tribal/Urban clinic electronic medical records, reporting systems Compiled since 2000 Northwest Portland Area Indian Health Board Indian Leadership for Indian Health Jessica Marcinkevage, PhD, MSPH EIS Officer, NPAIHB Managed by IHS, Albuquerque office Patient Visit, IHS/Tribal/Urban Site Clinic/ Area Server.ftp Area Tribal Epidemiology Centers What s available from the? Epi Data Epi Data (EDM) contains data on: Patient registration & demographics Electronic reporting systems IHS Server Data Integrity Export Tracking General Data Data Quality Userpop Patient encounter information THE FOR OREGON AI/AN COMMUNICABLE DISEASE SURVEILLANCE National Data Warehouse 4/17/ /17/ ICD-9 (clinical modification) codes for: Hepatitis A Six Communicable Diseases Hepatitis B & C (acute and chronic) Reporting sites in Oregon Gonorrhea Chlamydia Pertussis Analysis Compare with: 2 clinic reporting systems Calculate sensitivity, predictive value positive Oregon notifiable disease system Race-corrected Oregon Sites Reporting to, /17/ /17/

2 vs. 2 Clinic Reporting Systems 965 encounters with case-defining diagnoses 3 (0.3%) absent from vs. 2 Clinic Reporting Systems Laboratory Confirmed Cases Sensitivity Predictive value positive Hepatitis B 0* n/a n/a Hepatitis C 45* 49% 48% Gonorrhea 4 0% 0% Chlamydia % 25% *Data available for only 1 clinic Condition Oregon n Mean Age (y) n Mean Age (y) Hepatitis B Hepatitis C Gonorrhea Chlamydia p<0.05, comparison with 4/17/ /17/ /17/ Hepatitis B Diagnoses: Hepatitis B Diagnoses: Residents from urban counties* Oregon Hepatitis B 38% 82% Hepatitis C 35% 56% Gonorrhea 21% 76% Chlamydia 19% 56% *2010 Census Statistical Areas; p<0.05, comparison with 4/17/ /17/ /17/ Hepatitis B Diagnoses: Hepatitis C Diagnoses: Compare with OR Hep C Linked: x (maybe a table?) Hepatitis C Diagnoses: 4/17/ /17/ /17/

3 Hepatitis C Diagnoses: Gonorrhea Diagnoses: Compare with OR GC Linked: X (maybe a table?) Gonorrhea Diagnoses: 4/17/ /17/ /17/ Gonorrhea Diagnoses: Chlamydia Diagnoses: Chlamydia Diagnoses: 4/17/ /17/ /17/ Chlamydia Diagnoses: Conclusions Clinic reporting to accurate Next Steps Test accuracy of at area level Data limitations of Conduct analysis for Washington Representativeness at state-level: depends Share results with key stakeholders 4/17/ /17/ /17/

4 Acknowledgements Co-Authors IHS Division of Dr. Victoria Warren-Mears Epidemiology and Disease Dr. Richard Leman Prevention Dr. Thomas Weiser NPAIHB, Atlanta-based supervisors NPAIHB, Northwest Tribal Epicenter Portland Area IHS and Tribal Clinics EXTRA SLIDES Center for Surveillance, Epidemiology, and Laboratory Services Division of Scientific Education and Professional Development 4/17/ Resources Required for Portland Area IHS Extra slides IHS clearance and permission Access to statistical software package (e.g., SAS) Northwest Portland Area Indian Health Board (NPAIHB) Personnel to manage data collection, quality (Albuquerque) Userpop IHS (Albuquerque) National Data Warehouse General Data Data integrity Data quality Epi Data 4/17/ Stack Horizontal 234 Stack Horizontal 38 Join Overlap 1 Here Here Here Here Here Here Here Here 4

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