A Study on the Management and Application of Community Resident Health Data
|School||Tianjin Medical University|
|Course||Epidemiology and Biostatistics,|
|Keywords||resident health archive management system diabetes odds ratio|
Objective: The major purpose of this study is to build up a health management system of residents, to construct a superior information platform so that the unhealthy behavior style and the poor living habits in dwellers can be discovered in time. In the long run, we can enhance the residents’ health level and improve their health quality via/by performing some community health promotion work with pertinence.Methods: In this research the original data are obtained from a diabetes epidemiologic survey, from July to September in 2005, in Wang Ding Di community, Tianjin. Based on the data processing and analysis system under Office circumstance, we’ve accomplished the design of management system by using Access plus VBA. VBA(Visual Basic for Applications), the embedded language in Access is the Visual Basic system, which is especially made for Office software by Microsoft company. VBA is mainly compatible with Visual Basic, in addition, some other objects and classifications are added to it. The management system based on Access is a fully database.We take the questionnaire content of the project "Diabetes Epidemiologic Survey in Tianjin" as a design template, carrying out the research work in various ways of data input, data management, data query, data transmission, and basic statistical analysis. Meanwhile, taking full advantage of the adopted database information, we have analyzed the data by SAS in three major aspects: the characteristic of community demography, diabetes mono-factor, multiplicity. In the research, different analytical methods including t-test, rank sum test, x~2 test, Fisher exact test and non-conditional logistic regression analyses have been employed. The level of test isα=0.05 (two-side).Results: We have accomplished the development work of management system according to the design requirement, and the system has been established on the basis of Access. At present MS office is the most popular software in application, which can quickly set up a network management system with good qualities and at cheap cost, and which has no need for the installment of the extra operating ambient and the large-scale server. Besides, the user’s interface of the whole program is more friendly and concise. The visual interface coinciding with the form of paper questionnaire makes it more convenient and precise to some extent when the data are input. Furthermore, the operation of the overall system is a simply mouse clicking work without any participance of computer professionals, which especially meets the need of the health record management for the general practitioners. In this way, the basic information of every resident can be corresponding to pieces of information of multiple investigation questionnaires, simultaneously, the same information of investigation questionnaire can be corresponding to the information of multiple medical examinations. Finally, the design of data structure is especially suitable to the dynamic follow-up management and analyses (i.e. cohort study, Cox regression analysis) of the residents’ health record. And the system is capable of a strong inquiry function, a timely statistical analysis function and a dynamic result-display function. As a result, based on the mapping of local area network (LAN), the separation between the data acquisition and storage, and the data sharing, the system has series of perfect functions. The system can also implement the long range data transmission, since the establishment of the point-to-point network, and provide numerous external data interface, such as SPSS、SAS、Excel、dBase and text etc. as well so that users can utilizing different software to analyze data freely.Health archive, whose primary goal is to pay close attention to public health, is different from electron case history. Health archive also plays an important role in the work of diabetes prevention and control: to implement statistical analysis promptly, to detect risk factors such as unhealthy behavior style and living habits. Hence we can carry out health promotion with pertinence to improve the health level and quality of community inhabitants. The result of this research reveals that we should pay more attention to the aged and the intellectual while performing the work of community health promotion. The OR of age, of classification of occupation, and of physical strength is 1.409 (95%CI 1.052～1.887), 0.466 (95%CI 0.233～0.929) respectively. Coronary artery disease history, diabetes family history and WHR, as independent factors related to diabetes in this study with OR of 3.68 (95%CI 1.916～7.042) ,3.731 (95%CI 1.575～8.850), 22.446 (95%CI 2.512～200.594) respectively, should be the focus of community propagation and education in preventing and controlling diabetes. In addition, the diabetes suffering patients in this community intake more fresh vegetables (OR=1.429, 95%CI 1.059～1.927) and adequate fruits (OR=0.612, 95%CI 0.443～0.845) because of full awareness of self-health care. As expected, some acknowledged risk factors of diabetes, such as smoking, liquor drinking, exercise, tea drinking yielded the similar result. No significant results were found in our study and the further investigation needs to be conducted in the future.Conclusions: This system provides a highly efficient and cost-effective method, provides a friendly and concise user’s interface as well as its convenience. Also, it is strongly capable of data input, data inquiry, data output, timely statistical analysis as well as a dynamic display function. It has perfect network functions. Besides, the system is suitable to the dynamic management and follow-up analysis (i.e. cohort study, Cox regression analysis) of health archive of residents. The important purpose of constructing residents’ health archive is to guide people to change some unhealthy behavior styles and some poor living habits in so as to improve the health level of the communities. Based on this study, we should gradually expand the database including the information of prophylactic immunization, follow-up record, health examination records, birth control and so on and accomplish the integration of the multiple residents’ health archive in the future. The final objectives of such management system are to embody the information of the crucial precaution, the information of the integration of health archive, and the clinical information. In the long run, we can fulfill the success in the whole range management in residents’ health and realize the combination of disease prevention and disease control.