NHLBI Workshop
Data Needs for Cardiovascular Events, Management, and Outcomes
State-wide Surveillance - Dr. Eduardo Sanchez
After noting
that not all state health departments share the same set of responsibilities and
activities, Dr. Sanchez described the breadth of relevant data collection
efforts at the Texas State Department of Health, including those concerning
emergency medical services (EMS), hospital care, vital statistics, and chronic
disease measures. The state has numerous data sources, though many are
disparate. These include mortality data (inpatient and outpatient); hospital
discharge and cost data from more than 80% of the state’s hospitals; behavioral
data and trends from the Behavioral Risk Factor Surveillance System, the Youth
Tobacco Survey, and the Youth Risk Factor Surveillance System; Health Plan
Employer Data and Information Set; the Texas EMS/Trauma Registry; Medicaid and
Medicare data; and the national voluntary hospital reporting initiative data
available from CMS. Texas’ quality improvement organization (QIO) has focused
on the outpatient setting and has not looked at cardiovascular disease or stroke
but these diseases could potentially be added.
Dr. Sanchez identified several gaps and opportunities to
improve the applicability of these databases for CVD research. Integration of
data collected from various sources is needed, as is application of collected
data from such sources into information that can direct policy making and
program development. He suggested analyzing hospital discharge and cost data to
determine the cost of achieving the decline in MI rates in recent years. He
also emphasized the importance of tying local data to
national standards. Our definition of health care should be broadened to
include public health as well as health care delivery when collecting and
interpreting data as well as when using the results to inform policies and
programs. Outpatient health care delivery should include diverse community
settings such as churches, the workplace, and lay health worker settings for
data gathering as well as for health promotion. Greater adoption of electronic
medical records is expected to be very helpful in improving data collection and
linking among databases.
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