CVD Observation in Texas Cardiovascular Wellbeing and Health Program.


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General wellbeing reconnaissance is the progressing, deliberate gathering, examination, ... Upgraded rules for assessing general wellbeing observation frameworks: ...
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CVD Surveillance in Texas Cardiovascular Health and Wellness Program 2010 Weihua Li, MD, MPH Epidemiologist

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Goal of Surveillance Public wellbeing observation is the progressing, efficient accumulation, examination, translation, and scattering of information with respect to a wellbeing related occasion for use in general wellbeing activity to lessen bleakness and mortality and to enhance wellbeing. Source: Centers for Disease Control and Prevention. Overhauled rules for assessing general wellbeing observation frameworks: suggestions from the rules working gathering. MMWR 2001; 50 (No. RR-13).

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What Data is Collected and Measured? What are the Data Sources? How Do You Tell if a Value is Significant? How Data is Reported to the Public? Reconnaissance Measures Data Resources Statistics-One Test for Significance Report and Publications

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Surveillance Measure And Resources Morbidity: The event of an ailment or ailments in a populace Prevalence Hospitalizations Medicaid repayment EMS Response time Quality of consideration Mortality: The event of death in a populace Deaths

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CVD Surveillance Measures and Resources Health Service Region (HSR) † Dependent on test size

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Prevalence The quantity of existing instances of an illness or wellbeing condition in a populace at some assigned time How normal an infection is in a populace A sign of the degree of a wellbeing issue

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Incidence The rate of improvement of an ailment in a gathering over a specific era Three essential components to decide frequency rate: The numerator- number of new cases The denominator- population at danger Time- period amid which the cases accumulate

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Prevalence - Behavioral Risk Factor Surveillance System (BRFSS) Population-based, irregular digit dialed phone study Conducted every year by each of the 50 states, 3 domains, and the District of Columbia For more Information visit: http://www.dshs.state.tx.us/chs/brfss/default.sht http://www.cdc.gov/brfss/index.htm

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Prevalence - BRFSS Cardiovascular Disease or Stroke Prevalence included subsequent to (1999, 2001, 2003, 2005, 2006, 2007, 2008, 2009)  Cardiovascular Health included following (1999, 2001, 2003, 2005, 2007, 2009)  Heart Attack & Stroke signs and side effects included following 2001 (2001, 2003, 2005, 2009)  Action to control hypertension included following (2007, 2009) 

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CVD Prevalence - BRFSS Questions for Prevalence CVD-"Have you ever been told by a specialist, attendant, or other wellbeing proficient that you showed some kindness Attack, Myocardial Infarction, Angina, Coronary Heart Disease, or Stroke ?" Heart Disease-"Have you ever been told by a specialist, medical caretaker, or other wellbeing proficient that you showed at least a bit of kindness Attack, Myocardial Infarction, Angina, or Coronary Heart Disease ?" Stroke-"Have you ever been told by a specialist, medical caretaker, or other wellbeing proficient that you had a stroke ?"

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Prevalence - BRFSS Available Data All State, HSR, MSA, and a few provinces Demographics Race/ethnicity Gender Age Education Income Risk Factors

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Hospitalization-Texas Health Care Information Collections (THCIC) Hospital release information have been aggregated and organized by THCIC since 1999 Billing frames used to gathered information. Accordingly information gathered are authoritative, not clinical All CVD hospitalization is characterized as doctor\'s facility records posting as the essential determination ICD-9 Code ICD-9 Code for Cardiovascular Disease:390-448 For more data visit: http://www.dshs.tx.us/thcic/

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ICD 9 Codes for CVD Ischemic Heart Disease (ICD-9: 410-414) Heart Attack (ICD-9: 410) Hemorrhagic Stroke (ICD-9: 430-432) Ischemic Stroke (ICD-9: 436-438, 433, and 434) Congestive Heart Failure (ICD-9: 428) Hypertension (ICD-9: 401-405)

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Hospitalization - THCIC Available Data All State, HSR, MSA, TSA, and provinces Charges-$ Demographics Race/ethnicity Gender Age Payment Sources Patient Discharge Status Age-balanced Hospitalization Rates per 10,000

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Medicaid Reimbursement-Texas Health & Human Services Commission ( HHSC) Variables Claim Type-doctor, crisis division or in-patient doctor\'s facility Recipient-having no less than one case (doctor, ED, or doctor\'s facility) with an essential analysis of CVD Reimbursement - $

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Medicaid Reimbursement-HHSC CVD characterized as paid or in part paid cases with an essential conclusion of ICD-9 code: Cardiovascular Disease (ICD-9 CM: 410 - 414, 428, and 430 – 438) Ischemic Heart Disease (ICD-9: 410 - 414) Stroke (ICD-9: 430 - 438) Congestive Heart Failure (ICD-9: 428) Hypertension (ICD-9: 401-405)

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Medicaid Reimbursement – Health and Human Services Commission (HHSC) Available Data Statewide Claim Type-doctor, crisis office or inpatient doctor\'s facility Reimbursement - $

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EMS Data-Texas EMS/Trauma Registry Suspected Illness Types CVD characterized as heart failure, heart musicality aggravation, and mid-section torment/inconvenience Stroke characterized as Stroke/CVA Medical-related calls just (i.e. calls solely identified with injury were prohibited) 911 calls just (no between office exchanges) Texas inhabitants just

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EMS Data-Texas EMS/Trauma Registry Available Data State, HSR, MSA, TSA, Border and No-outskirts districts Variables include: Total Number of Transports Response Time Scene Time Transport Time Delivery Time

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Quality of Care - Health Effectiveness Data and Information Set (HEDIS) HEDIS is a device utilized by more than 90 percent of America\'s wellbeing arrangements to quantify execution on imperative measurements of consideration and administration. It is an arrangement of institutionalized execution measures intended to furnish buyers and customers with the data they have to dependably look at the execution of medicinal services arranges. For more Information visit: http://www.opic.state.tx.us/docs/611_guidetotexashmoquality2009.pdf

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Quality of Care - HEDIS Available measures State Variables include: Blood Pressure Control Cholesterol Management for Patients with Cardiovascular Condition: LDL-C Screening Cholesterol Management for Patients with Cardiovascular Condition: LDL-C level <130 mg/dL Beta Blocker Treatment after a Heart Attack

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Mortality-Center for Health Statistics (CHS) A CVD passing is characterized as any demise for which CVD is recorded as the fundamental cause Before 1999, Used ICD - 9 code. After 1999 Using ICD 10 code For more Information visit: http://www.dshs.state.tx.us/versus/default.shtm

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Mortality - CHS ICD 10 code: Cardiovascular Disease (ICD-10: I00-I99) Ischemic Heart Disease (ICD-10: I20-I25) Stroke (ICD-10: I60-I69) Congestive Heart Failure (ICD-10: I50) Hypertension (ICD-10: I11-I13)

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Mortality - CHS Available Data State, HSR, MSA, TSA, and regions Age-balanced Rates per 100,000 Demographics Race/ethnicity Gender (age particular)

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Texas Population Data - CHS Used while planning demographic data or ascertaining number of situations when given rate Center for Health Statistics (CHS) gives populace appraisals and projections Population gauges more solid than projections http://www.dshs.state.tx.us/chs/popdat/default.shtm

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Statistics One Test for Significance Confidence Interval (CI) is a factual measure that is considered by numerous disease transmission specialist as important CI is one in a rundown of a few factual tests to translate watched affiliations CIs are impacted by the variability of the information and the example size

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Interpreting CI If the certainty interims don\'t cover, the test is measurably critical. Cardiovascular Health and Wellness Program, DSHS

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Interpreting CI If the certainty interims cover, the test is not measurably huge. Cardiovascular Health and Wellness Program, DSHS

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Reports and Publications Chronic Disease Burden Report http://www.dshs.state.tx.us/constant/pdf/CDBR2010.pdf Texas CVD Burden Report http://www.dshs.state.tx.us/wellbeing/default.shtm Fact sheets Posters PowerPoint presentations

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Data Requests Data solicitations can be submitted to the CHW disease transmission expert by means of email: Weihua.Li@dshs.state.tx.us

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