DNP 825 How can large, aggregated databases be used to improve population health?

How can large, aggregated databases be used to improve population health?

Key Attributes of Databases

In reviewing the considerable variation in databases that might be accessed, controlled, or acquired by HDOs, the committee sought a simple way to characterize them by key attributes. It decided on two critical dimensions of databases: comprehensiveness and inclusiveness. (Because these terms are used with distinct meanings in this report, they are italicized whenever used.)

Comprehensiveness. Comprehensiveness describes the completeness of records of patient care events and information relevant to an individual patient (Table 2-1).⁴ It refers to the amount of information one has on an individual both for each patient encounter with the health care system and for all of a patient’s encounters over time (USDHHS, 1991, refers to this as completeness). A record that is comprehensive contains: demographic data, administrative data, health risks and health status, patient medical history, current management of health conditions, and outcomes data. Each category is described briefly below.

Comprehensiveness: Data Elements as a Critical Dimension of Health Care Databases.

Demographic data consist of facts such as age (or date of birth), gender, race and ethnic origin, marital status, address of residence, names of and other information about immediate family members, and emergency information. Information about employment status (and employer), schooling and education, and some indicator of socioeconomic class might also appear.
Administrative data include facts about health insurance such as eligibility and membership, dual coverage (when relevant), and required copayments and deductibles for a given benefit package. With respect to services provided (e.g., diagnostic tests or outpatient procedures), such data also typically include charges and perhaps amounts paid. Administrative data commonly identify providers with a unique identifier and possibly give additional provider-specific facts; the latter might include kind of practitioner (physician, podiatrist, psychologist), physician specialty, and nature of institution (general or specialty hospital, physician office or clinic, home care agency, nursing home, and so forth).
Health risks and health status Health risk information reflects behavior and lifestyle (e.g., whether an individual uses tobacco products or engages regularly in strenuous exercise) and facts about family history and genetic factors (e.g., whether an individual has first-degree family members with a specific type of cancer or a propensity for musculoskeletal disease).

Health status (or health-related quality of life), generally reported by individuals themselves, reflects domains of health such as physical functioning, mental and emotional well-being, cognitive functioning, social and role functioning, and perceptions of one’s health in the past, present, and future and compared with that of one’s peers. Health status and quality-of-life measures are commonly considered outcomes of health care, but evaluators and researchers also need such information to take account in their analyses of the mix of patients and the range of severity of health conditions.

Patient medical history involves data on previous medical encounters such as hospital admissions, surgical procedures, pregnancies and live births, and the like; it also includes information on past medical problems and possibly family history or events (e.g., alcoholism or parental divorce). Again, although such facts are significant for good patient care, they may also be important for case-mix and severity adjustment.

DNP 825 How can large, aggregated databases be used to improve population health
Current medical management includes the content of encounter forms or parts of the patient record. Such information might reflect health screening, current health problems and diagnoses, allergies (especially those to medications), diagnostic or therapeutic procedures performed, laboratory tests carried out, medications prescribed, and counseling provided.
Outcomes data encompass a wide choice of measures of the effects of health care and the aftermath of various health problems across a spectrum from death to high levels of functioning and well-being; they can also reflect health care events such as readmission to hospital or unexpected complications or side effects of care. Finally, they often include measures of satisfaction with care. Outcomes assessed weeks or months after health care events, and by means of reports directly from individuals (or family members), are desirable, although these are likely to be the least commonly found in the secondary databases under consideration here.

The more comprehensive the database is, the more current and possibly more sensitive information about individuals is likely to be. This suggests that comprehensiveness as envisioned here will have a direct correlation with concerns about privacy and confidentiality. By analogy, the Department of Defense treats information with increasingly higher levels of security as it becomes more comprehensive, even when the aggregated information is not considered sensitive.

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Important information for writing discussion questions and participation

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Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

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Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

Your response needs to be a minimum of 150 words (not including your list of references)
There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
Include in-text citations in your response
Do not include quotes—instead summarize and paraphrase the information
Follow APA-7th edition
Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

A minimum of 6 responses per week, on at least 3 days of the week.
Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
Each response needs to be at least 75 words in length (does not include your list of references)
Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
Follow APA 7th edition
Points will be deducted if the above is not followed
Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
Here are some helpful links
Student paper example
Citing Sources
The Writing Center is a great resource