Publication
Helping decision-makers visualize inequities in health impact assessment : linked electronic records, mortality and regional disparities in Portugal
| dc.contributor.author | Nicolau, Leonor Bacelar | |
| dc.contributor.author | Rodrigues, T. | |
| dc.contributor.author | Fernandes, E. | |
| dc.contributor.author | Lobo, M. F. | |
| dc.contributor.author | Nisa, C. | |
| dc.contributor.author | Azzone, V. | |
| dc.contributor.author | Pinto, A. Teixeira | |
| dc.contributor.author | Gonçalves, F. N. Rocha | |
| dc.contributor.author | Azevedo, L. F. | |
| dc.contributor.author | Freitas, A. | |
| dc.contributor.author | Normand, S. T. | |
| dc.contributor.author | Pereira, A. Costa | |
| dc.contributor.author | Miguel, J. Pereira | |
| dc.date.accessioned | 2018-05-28T16:33:55Z | |
| dc.date.available | 2018-05-28T16:33:55Z | |
| dc.date.issued | 2016 | |
| dc.description | Copyright © 2016 Published by Elsevier Inc | pt_PT |
| dc.description.abstract | Objectives: Show how multivariate methods outputs visualization may help decision-makers identify inequities through health impact assessment (HIA). Show how a policy promoting quality of linked Electronic Health Records (EHR) regarding Acute Myocardial Infarction (AMI) patients may be associated to mortality and regional inequities. Methods: Data: Adults (>=20 years) admitted in Portuguese NHS Hospitals with AMI diagnosis during the 2nd semester 2012, followed regularly in NHS Primary Care (PC) during 2013. Variables: Mortality outcome at December 31 2013, 4 PC registered indicators- Blood Pressure, Cholesterol, Triglycerides, Waist Circumference, Body Mass Index (BMI); 5 regions Norte, Centro, LVT, Alentejo, Algarve; adjustment variables sex, age, AMI hospital readmissions during the 2nd semester 2012, surgery during hospital admission, mean admission duration>6 days, hospital diagnosis>=6. Statistical Procedures: X2 and Fisher exact tests; logistic regressions, simple and stratified by region, estimating crude and adjusted ORs (and 95%CI); multivariate correspondence analysis (MCA). Results: Regions Algarve and LVT present the highest no-registration percentages for every indicator. Norte, usually followed by Algarve and then Centro, has the lowest percentage of no-registration. Patients without registered information for all health indicators are more than twice as likely to be deceased, than patients with information registered (OR>2.0). Norte presents higher OR for Cholesterol and Triglycerides (OR>13.0) and Blood pressure (OR>3) and Alentejo for BMI (OR near7). Centro presents high values especially regarding Cholesterol and Triglycerides (3.173 and 4.409). MCA summarizes previous findings with a very clear, visual graphical aid. Conclusions: HIA assesses health impacts (here, mortality) of policies (EHR policy to promote PC uniform information registration), identifying groups where effects are worse (regional equity concerns). Disparities between regions are found regarding registering information, but also concerning association patterns of mortality and registration of these health indicators. Complex multivariate methodologies may generate visual outputs easily interpreted by decision-makers. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | Value in Health 1 9 (2016) A347 – A766 A623 | pt_PT |
| dc.identifier.doi | 10.1016/j.jval.2016.09.1591 | pt_PT |
| dc.identifier.issn | 1098-3015 | |
| dc.identifier.uri | http://hdl.handle.net/10451/33695 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Elsevier | pt_PT |
| dc.relation.publisherversion | https://onlinelibrary.wiley.com/journal/15244733 | pt_PT |
| dc.title | Helping decision-makers visualize inequities in health impact assessment : linked electronic records, mortality and regional disparities in Portugal | pt_PT |
| dc.type | conference object | |
| dspace.entity.type | Publication | |
| oaire.citation.issue | 7 | pt_PT |
| oaire.citation.startPage | A623 | pt_PT |
| oaire.citation.title | Value in Health | pt_PT |
| oaire.citation.volume | 19 | pt_PT |
| rcaap.rights | restrictedAccess | pt_PT |
| rcaap.type | conferenceObject | pt_PT |