Int J Med Inform - Decline in mortality with the Belize Integrated Patient-Centred Country Wide Health Information System (BHIS) with embedded program management.

Tópicos

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{ survey(1388) particip(1329) question(1065) }
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{ decis(3086) make(1611) patient(1517) }
{ activ(1452) weight(1219) physic(1104) }
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{ detect(2391) sensit(1101) algorithm(908) }

Resumo

CKGROUND: Belize deployed a country-wide fully integrated patient centred health information system with eight embedded disease management algorithms and simple analytics in 2007 for $4 (Cad)/citizen.OBJECTIVES: This study evaluated BHIS uptake by health care workers, and pre and post BHIS deployment mortality in selected areas and public health care expenditures.METHODS: BHIS encounter data were compared to encounter data from required Ministry of Health reports from licensed health care entities. De-identified vital statistics death data for the eight BHIS protocol disease domains and three non-protocol domains were compared from 2005 to 2011. Belize population data came from the Statistical Institute of Belize (2005-2009) and from Belize census (2010) and estimate (2011). Public health system expenditures were compared by fiscal years (2000-2012).RESULTS: BHIS captured over 90% healthcare encounters by year one, 95% by year two. Mortality rates decreased in the eight BHIS protocol domains (each 2005 vs. 2011, all p<0.02) vs. an increase or little change in the three domains without protocols. Hypertension related deaths dropped from 1st cause of death in 2003 to 9th by 2010. Public expenditures on healthcare steadily rose until 2009 but then declined slightly for the next 3 years.CONCLUSION: For modest investment, BHIS was well accepted nationwide and following deployment, mortality in the eight BHIS disease management algorithm domains declined significantly and expenditures on public healthcare stabilized.

Resumo Limpo

ckground beliz deploy countrywid fulli integr patient centr health inform system eight embed diseas manag algorithm simpl analyt cadcitizenobject studi evalu bhis uptak health care worker pre post bhis deploy mortal select area public health care expendituresmethod bhis encount data compar encount data requir ministri health report licens health care entiti deidentifi vital statist death data eight bhis protocol diseas domain three nonprotocol domain compar beliz popul data came statist institut beliz beliz census estim public health system expenditur compar fiscal year result bhis captur healthcar encount year one year two mortal rate decreas eight bhis protocol domain vs p vs increas littl chang three domain without protocol hypertens relat death drop st caus death th public expenditur healthcar steadili rose declin slight next yearsconclus modest invest bhis well accept nationwid follow deploy mortal eight bhis diseas manag algorithm domain declin signific expenditur public healthcar stabil

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