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This book provides a practical guide to the design and implementation of health information systems in developing countries. Noting that most existing systems fail to deliver timely, reliable, and relevant information, the book responds to the urgent need to restructure systems and make them work as both a resource for routine decisions and a powerful tool for improving health services. With this need in mind, the authors draw on their extensive personal experiences to map out strategies, pinpoint common pitfalls, and guide readers through a host of conceptual and technical options. Information needs at all levels - from patient care to management of the national health system - are considered in this comprehensive guide. Recommended lines of action are specific to conditions seen in government-managed health systems in the developing world. In view of common constraints on time and resources, the book concentrates on strategies that do not require large resources, highly trained staff, or complex equipment. Throughout the book, case studies and numerous practical examples are used to explore problems and illustrate solutions. Details range from a list of weaknesses that plague most existing systems, through advice on when to introduce computers and how to choose appropriate software and hardware, to the hotly debated question of whether patient records should be kept by the patient or filed at the health unit. The book has fourteen chapters presented in four parts. Chapters in the first part, on information for decision-making, explain the potential role of health information as a managerial tool, consider the reasons why this potential is rarely realized, and propose general approaches for reform which have proved successful in several developing countries. Presentation of a six-step procedure for restructuring information systems, closely linked to an organizational model of health services, is followed by a practical discussion of the decision-making process. Reasons for the failure of most health information to influence decisions are also critically assessed. Against this background, the second and most extensive part provides a step-by-step guide to the restructuring of information systems aimed at improving the quality and relevance of data and ensuring their better use in planning and management. Steps covered include the identification of information needs and indicators, assessment of the existing system, and the collection of both routine and non-routine data using recommended procedures and instruments. Chapters also offer advice on procedures for data transmission and processing, and discuss the requirements of systems designed to collect population-based community information. Resource needs and technical tools are addressed in part three. A comprehensive overview of the resource base - from staff and training to the purchase and maintenance of equipment - is followed by chapters offering advice on the introduction of computerized systems in developing countries, and explaining the many applications of geographic information systems. Practical advice on how to restructure a health information system is provided in the final part, which considers how different interest groups can influence the design and implementation of a new system, and proposes various design options for overcoming specific problems. Experiences from several developing countries are used to illustrate strategies and designs in terms of those almost certain to fail and those that have the greatest chances of success
Sixth edition of the hugely successful, internationally recognised textbook on global public health and epidemiology, with 3 volumes comprehensively covering the scope, methods, and practice of the discipline
Health inequalities blight lives, generate enormous costs, and exist everywhere. This book is the definitive all-in-one guide for anyone who wishes to learn about, commission, and use distributional cost-effectiveness analysis to promote both equity and efficiency in health and healthcare.
Over the past twenty years, many low- and middle-income countries have experimented with health insurance options. While their plans have varied widely in scale and ambition, their goals are the same: to make health services more affordable through the use of public subsidies while also moving care providers partially or fully into competitive markets. Until now, however, we have known little about the actual effects of these dramatic policy changes. Understanding the impact of health insurance-based care is key to the public policy debate of whether to extend insurance to low-income populationsand if so, how to do itor to serve them through other means.
Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.
Telemedicine networks to support healthcare workers in resource-limited settings (often for humanitarian purposes) have evolved over the last decade or so in a largely autonomous way. Communication between them has been informal and relatively limited in scope. This situation could be improved by developing a comprehensive approach to the collection and dissemination of information. A recent review identified seven telemedicine networks, each of which had been in operation for at least five years and which provided store-and-forward telemedicine services to doctors in low- and middle-income countries. These networks provide clinically useful services and improved healthcare access. However, like much of telemedicine, the formal evidence for their cost-effectiveness remains weak. Topics of current research interest therefore include the cost-effectiveness of telemedicine in resource-limited settings. Outcomes data (and methods for gathering it) such as patient quality of life following a telemedicine episode, the knowledge-gain of healthcare staff involved in telemedicine, and staff recruitment and retention in rural areas are also of interest. Finally, there is little published information about the performance of these telemedicine networks (and methods for measuring it), about how best to manage them, and about how to share resources between them. A collection of articles reporting the current evidence supporting the use of telemedicine in resource-limited settings would build the evidence base and should provide a focus for future research. It would also serve to raise the profile of this potentially important research field.
Statistical tools to analyze correlated binary data are spread out in the existing literature. This book makes these tools accessible to practitioners in a single volume. Chapters cover recently developed statistical tools and statistical packages that are tailored to analyzing correlated binary data. The authors showcase both traditional and new methods for application to health-related research. Data and computer programs will be publicly available in order for readers to replicate model development, but learning a new statistical language is not necessary with this book. The inclusion of code for R, SAS, and SPSS allows for easy implementation by readers. For readers interested in learning more about the languages, though, there are short tutorials in the appendix. Accompanying data sets are available for download through the book s website. Data analysis presented in each chapter will provide step-by-step instructions so these new methods can be readily applied to projects. Researchers and graduate students in Statistics, Epidemiology, and Public Health will find this book particularly useful.
The goal of eliminating disparities in health care in the United States remains elusive. Even as quality improves on specific measures, disparities often persist. Addressing these disparities must begin with the fundamental step of bringing the nature of the disparities and the groups at risk for those disparities to light by collecting health care quality information stratified by race, ethnicity and language data. Then attention can be focused on where interventions might be best applied, and on planning and evaluating those efforts to inform the development of policy and the application of resources. A lack of standardization of categories for race, ethnicity, and language data has been suggested as one obstacle to achieving more widespread collection and utilization of these data. Race, Ethnicity, and Language Data identifies current models for collecting and coding race, ethnicity, and language data; reviews challenges involved in obtaining these data, and makes recommendations for a nationally standardized approach for use in health care quality improvement.