The IHS primary care provider最新文献

Evaluating an Electronic Measure of Colorectal Cancer Screening at Indian Health Service Facilities, 2008-2010. 2008-2010年印度卫生服务机构结肠直肠癌筛查电子措施评估。

The IHS primary care provider Pub Date : 2014-06-01

Diana Redwood, Anil Suryaprasad, Donald Haverkamp, Charlene Wong, Ellen Provost, David Espey

{"title":"Evaluating an Electronic Measure of Colorectal Cancer Screening at Indian Health Service Facilities, 2008-2010.","authors":"Diana Redwood, Anil Suryaprasad, Donald Haverkamp, Charlene Wong, Ellen Provost, David Espey","doi":"","DOIUrl":"","url":null,"abstract":"Background: Colorectal cancer (CRC) is a leading cause of cancer mortality in American Indian and Alaska Native (AIAN) people, and incidence rates vary considerably among AIAN populations throughout the United States. Screening has the potential to prevent CRC deaths by detection and treatment of early disease or removal of precancerous polyps. Surveillance of CRC screening is critical to efforts to improve delivery of this preventive service, but existing CRC screening surveillance methods for AIAN are limited. The Government Performance and Results Act (GPRA) CRC screening clinical care measure provides data on CRC screening among AIAN populations.Purpose: The aim of this study was to evaluate the accuracy of the GPRA measure for CRC screening (sensitivity, specificity, positive predictive value and negative predictive value), determine reasons for CRC screening misclassification (procedures noted as screening when they were actually diagnostic exams), and to suggest opportunities for improving surveillance for CRC screening nationwide for AIAN populations.Methods: Medical record reviews (paper and electronic) were compared to the GPRA-reported CRC screening status for 1,071 patients receiving care at tribal health facilities. A total of 8 tribal health facilities (2 small, 3 medium, and 3 large) participated in the study from the Pacific Coast, the Southwest, the Southern Plains, and Alaska IHS regions. Screening-eligible patients were identified using queries of the local electronic health record from January 2007 to December 2008, and medical chart reviews were completed at participating facilities from September 2008 to June 2010.Results: Among 545 patients classified as screened by the GPRA measure, 305 (56%, CI: 52%-60%) had a false positive for screening as compared with medical record review. The overall sensitivity of the GPRA measure for CRC screening was 93% (CI=89%-95%) while specificity was 62% (CI: 59%-66%). The most common reasons for misclassification were for diagnostic or surveillance tests to be recorded as screening (67%), as well as medical record miscoding (18%) due to miscoding, charting errors, screenings performed outside the IHS, testing for a non-screening purpose, and categorization of patients as screened when a test had been ordered but not actually completed.Conclusions: This study found that the GPRA CRC screening clinical measure overestimates the true screening rate due to the inclusion of diagnostic and surveillance exams, especially colonoscopy, as well as misclassification errors. The results of this study suggest a need to more accurately use the ICD-9 diagnostic code V76.51, which was associated with frequent coding errors. In combination with other programmatic efforts that focus on screening average- risk, asymptomatic American Indian and Alaska Native persons, improving the coding used for","PeriodicalId":85704,"journal":{"name":"The IHS primary care provider","volume":"39 6","pages":"86-93"},"PeriodicalIF":0.0,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4532665/pdf/nihms-712336.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34092552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treating Sexual Contacts of Gonorrhea and Chlamydia Cases: A Critical Component of STD Control Among AI/AN Populations. 治疗淋病和衣原体病例的性接触者：对淋病和衣原体病例的性接触者进行治疗：美国原住民/印第安人性传播疾病控制的重要组成部分。

The IHS primary care provider Pub Date : 2013-04-01

Melanie Taylor

引用次数: 0

Challenging Horizons: Identifying the Burden of Sexually Transmitted Disease (STD) in Indian Country. 挑战视野:确定印度国家性传播疾病(STD)的负担。

The IHS primary care provider Pub Date : 2012-04-01

Melanie M Taylor, Scott Tulloch, Lori de Ravello

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Sexually Transmitted Disease Surveillance: Summary Points from the Indian Health Service STD Surveillance Report, 2004. 性传播疾病监测:2004年印度卫生服务性病监测报告要点摘要。

The IHS primary care provider Pub Date : 2007-06-01 DOI: 10.1037/e637262007-001

Melanie M. Taylor, S. Tulloch, L. de Ravello, J. Cheek, D. Wong

{"title":"Sexually Transmitted Disease Surveillance: Summary Points from the Indian Health Service STD Surveillance Report, 2004.","authors":"Melanie M. Taylor, S. Tulloch, L. de Ravello, J. Cheek, D. Wong","doi":"10.1037/e637262007-001","DOIUrl":"https://doi.org/10.1037/e637262007-001","url":null,"abstract":"Sexually transmitted diseases (STDs) impose a significant burden on the Indian Health Service (IHS) health care system and on American Indians and Alaska Native (AI/AN) people as a whole. AI/AN populations are one of the smallest racial groups in the US, representing between 0.9% 1.5% of the population according to Census 2000, but are disproportionately affected by STDs. In 2004, among all races and ethnicities, AI/AN had the second highest rates of chlamydia, gonorrhea, and primary and secondary (P&S) syphilis. In 2004, reported case rates of chlamydia, gonorrhea, and primary and secondary syphilis among AI/AN were 2 to 6 times higher than comparable rates for whites. The publication of the Indian Health Surveillance Report on Sexually Transmitted Diseases (STD), 2004 represents the first report dedicated to the status of STD morbidity among AI/AN. This report summarizes key findings from the larger report that was produced as part of a collaborative effort between the Centers for Disease Control and Prevention (CDC) and IHS. Findings from this report are intended to increase awareness regarding the burden of STDs in AI/AN populations, which may lead to improvements in STD testing and clinical care, and increases in funding and research activities related to STD prevention and control in these communities.1 HHS Public Access Author manuscript IHS Prim Care Provid. Author manuscript; available in PMC 2019 October 10.","PeriodicalId":85704,"journal":{"name":"The IHS primary care provider","volume":"32 6 1","pages":"167-170"},"PeriodicalIF":0.0,"publicationDate":"2007-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57930297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Norplant implants. Norplant植入物。

The IHS primary care provider Pub Date : 1993-06-01

E Henley

引用次数: 0