scholarly journals Active Surveillance of Adverse Events Following Human Papillomavirus Vaccination: Feasibility Pilot Study Based on the Regional Health Care Information Platform in the City of Ningbo, China (Preprint)

2019 ◽  
Author(s):  
Zhike Liu ◽  
Liang Zhang ◽  
Yu Yang ◽  
Ruogu Meng ◽  
Ting Fang ◽  
...  
Keyword(s):  
Health Care ◽  
Active Surveillance ◽  
Hpv Vaccination ◽  
Vaccine Safety ◽  
Health Care Information ◽  
Regional Health ◽  
Information Platform ◽  
Regional Health Care ◽  
Identity Card ◽  
Care Information

BACKGROUND Comprehensive safety data for vaccines from post-licensure surveillance, especially active surveillance, could guide administrations and individuals to make reasonable decisions on vaccination. Therefore, we designed a pilot study to assess the capability of a regional health care information platform to actively monitor the safety of a newly licensed vaccine. OBJECTIVE This study aimed to conduct active surveillance of human papillomavirus (HPV) vaccine safety based on this information platform. METHODS In 2017, one of China’s most mature information platforms with superior data linkage was selected. A structured questionnaire and open-ended interview guidelines were developed to investigate the feasibility of active surveillance following HPV vaccination using the regional health care information platform in Ningbo. The questionnaire was sent to participants via email, and a face-to-face interview was conducted to confirm details or resolve discrepancies. RESULTS Five databases that could be considered essential to active surveillance of vaccine safety were integrated into the platform starting in 2015. Except for residents' health records, which had a coverage rate of 87%, the data sources covered more than 95% of the records that were documented in Ningbo. All the data could be inherently linked using the national identity card. There were 19,328 women who received the HPV vaccine, and 37,988 doses were administered in 2017 and 2018. Women aged 30-40 years accounted for the largest proportion. Quadrivalent vaccination accounted for 73.1% of total vaccination, a much higher proportion than that of bivalent vaccination. Of the first doses, 60 (60/19,328, 0.31%) occurred outside Ningbo. There were no missing data for vaccination-relevant variables, such as identity card, vaccine name, vaccination doses, vaccination date, and manufacturer. ICD-10 coding could be used to identify 9,180 cases using a predefined list of the outcomes of interest, and 1.88% of these cases were missing the identity card. During the 90 days following HPV vaccination, 4 incident cases were found through the linked vaccination history and electronic medical records. The combined incident rate of rheumatoid arthritis, optic neuritis, and Henoch-Schonlein purpura was 8.84/100,000 doses of bivalent HPV, and the incidence rate of rheumatoid arthritis was 3.75/100,000 doses of quadrivalent HPV. CONCLUSIONS This study presents an available approach to initiate an active surveillance system for adverse events following HPV vaccination, based on a regional health care information platform in China. An extended observation period or the inclusion of additional functional sites is warranted to conduct future hypothesis-generating and hypothesis-confirming studies for vaccine safety concerns.

scholarly journals Active Surveillance of Adverse Events Following Human Papillomavirus Vaccination: Feasibility Pilot Study Based on the Regional Health Care Information Platform in the City of Ningbo, China

10.2196/17446 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e17446
Author(s):  
Zhike Liu ◽  
Liang Zhang ◽  
Yu Yang ◽  
Ruogu Meng ◽  
Ting Fang ◽  
...  
Keyword(s):  
Health Care ◽  
Active Surveillance ◽  
Hpv Vaccination ◽  
Vaccine Safety ◽  
Health Care Information ◽  
Regional Health ◽  
Information Platform ◽  
Regional Health Care ◽  
Identity Card ◽  
Care Information

Background Comprehensive safety data for vaccines from post-licensure surveillance, especially active surveillance, could guide administrations and individuals to make reasonable decisions on vaccination. Therefore, we designed a pilot study to assess the capability of a regional health care information platform to actively monitor the safety of a newly licensed vaccine. Objective This study aimed to conduct active surveillance of human papillomavirus (HPV) vaccine safety based on this information platform. Methods In 2017, one of China’s most mature information platforms with superior data linkage was selected. A structured questionnaire and open-ended interview guidelines were developed to investigate the feasibility of active surveillance following HPV vaccination using the regional health care information platform in Ningbo. The questionnaire was sent to participants via email, and a face-to-face interview was conducted to confirm details or resolve discrepancies. Results Five databases that could be considered essential to active surveillance of vaccine safety were integrated into the platform starting in 2015. Except for residents' health records, which had a coverage rate of 87%, the data sources covered more than 95% of the records that were documented in Ningbo. All the data could be inherently linked using the national identity card. There were 19,328 women who received the HPV vaccine, and 37,988 doses were administered in 2017 and 2018. Women aged 30-40 years accounted for the largest proportion. Quadrivalent vaccination accounted for 73.1% of total vaccination, a much higher proportion than that of bivalent vaccination. Of the first doses, 60 (60/19,328, 0.31%) occurred outside Ningbo. There were no missing data for vaccination-relevant variables, such as identity card, vaccine name, vaccination doses, vaccination date, and manufacturer. ICD-10 coding could be used to identify 9,180 cases using a predefined list of the outcomes of interest, and 1.88% of these cases were missing the identity card. During the 90 days following HPV vaccination, 4 incident cases were found through the linked vaccination history and electronic medical records. The combined incident rate of rheumatoid arthritis, optic neuritis, and Henoch-Schonlein purpura was 8.84/100,000 doses of bivalent HPV, and the incidence rate of rheumatoid arthritis was 3.75/100,000 doses of quadrivalent HPV. Conclusions This study presents an available approach to initiate an active surveillance system for adverse events following HPV vaccination, based on a regional health care information platform in China. An extended observation period or the inclusion of additional functional sites is warranted to conduct future hypothesis-generating and hypothesis-confirming studies for vaccine safety concerns.

Usefulness of a Regional Health Care Information System in primary care

2008 ◽  
Vol 91 (2) ◽  
pp. 175-181 ◽  
Author(s):  
Marianne C. Maass ◽  
Paula Asikainen ◽  
Tiina Mäenpää ◽  
Olli Wanne ◽  
Tarja Suominen
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Information System ◽  
Health Care Information ◽  
Regional Health ◽  
Regional Health Care ◽  
Care Information

scholarly journals Speech, Language and Hearing services in Primary Health Care in Brazil: an analysis of provision and an estimate of shortage, 2005-2015

Revista CEFAC ◽  
2018 ◽  
Vol 20 (3) ◽  
pp. 353-362 ◽  
Author(s):  
Larissa Hellen Teixeira Viégas ◽  
Tatiane Costa Meira ◽  
Brenda Sousa Santos ◽  
Yukari Figueroa Mise ◽  
Vladimir Andrei Rodrigues Arce ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Ecological Study ◽  
Descriptive Analysis ◽  
National Registry ◽  
Health Care Information ◽  
System A ◽  
Primary Health ◽  
Care Information ◽  
Using Data

ABSTRACT Objective: to investigate the evolution and estimate the shortage of Speech, Language and Hearing professionals in Primary Health Care between 2005 and 2015. Methods: a mixed ecological study using data from the National Registry of Health Facilities and the Primary Health Care Information System. A descriptive analysis regarding the evolution of the number of professionals working in Primary Health Care over this period, in Brazilian states and regions, was conducted. The ratio of professionals per 100,000 inhabitants for the years 2005, 2010 and 2015, and the shortages in 2015, were estimated. Results: in 2005, there were 1,717 professionals working in Primary Health Care, that is, one per 100,000 inhabitants. In 2015, there were 4,124, increasing to 2.1/100,000. In 2015, the shortage in supply was 55.1%, varying widely across the states. Conclusion: the shortage in supply is equivalent to an absence of Speech, Language and Hearing service coverage within Primary Health Care for more than half of the Brazilian population. It is worth noting that a conservative parameter was adopted to conduct this estimate. The results suggest a process of consolidation for the inclusion of Speech, Language and Hearing professionals within Primary Health Care, however, still characterized by insufficient and unequal supply across the nation.

scholarly journals Optimizing Scarce Resource Allocation During COVID-19: Rapid Creation of a Regional Health-Care Coalition and Triage Teams in San Diego County, California

2020 ◽  
pp. 1-7
Author(s):  
Asha Devereaux ◽  
Holly Yang ◽  
Gilbert Seda ◽  
Viji Sankar ◽  
Ryan C. Maves ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Resource Allocation ◽  
San Diego ◽  
Scarce Resource ◽  
Successful Implementation ◽  
Regional Health ◽  
Incident Command ◽  
Regional Health Care ◽  
Crisis Care

ABSTRACT Successful management of an event where health-care needs exceed regional health-care capacity requires coordinated strategies for scarce resource allocation. Publications for rapid development, training, and coordination of regional hospital triage teams to manage the allocation of scarce resources during coronavirus disease 2019 (COVID-19) are lacking. Over a period of 3 weeks, over 100 clinicians, ethicists, leaders, and public health authorities convened virtually to achieve consensus on how best to save the most lives possible and share resources. This is referred to as population-based crisis management. The rapid regionalization of 22 acute care hospitals across 4500 square miles in the midst of a pandemic with a shifting regulatory landscape was challenging, but overcome by mutual trust, transparency, and confidence in the public health authority. Because many cities are facing COVID-19 surges, we share a process for successful rapid formation of health-care care coalitions, Crisis Standard of Care, and training of Triage Teams. Incorporation of continuous process improvement and methods for communication is essential for successful implementation. Use of our regional health-care coalition communications, incident command system, and the crisis care committee helped mitigate crisis care in the San Diego and Imperial County region as COVID-19 cases surged and scarce resource collaborative decisions were required.

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