衡量土著居民和托雷斯海峡岛民护理中的重要因素:对可用于评估慢性病护理的全科数据集的审查。

Liam McBride Kelly, Deborah Wong, Andrea Timothy
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摘要

背景 澳大利亚有大量数据集,提供从临床信息系统中提取的去标识化初级医疗保健数据供研究使用。本研究对这些数据集进行了审查,以了解这些数据集为土著居民和托雷斯海峡岛民提供慢性病护理的能力,以及数据收集和管理安排在多大程度上体现了土著数据主权原则。方法 收集初级医疗保健临床信息系统数据、在全国范围内收集数据并包含原住民和托雷斯海峡岛民数据的数据集均被纳入研究范围。我们在 PubMed 和公共互联网上搜索符合纳入标准的数据提供者。我们制定了一个框架来对数据提供者进行跨领域评估,包括代表性、可用性、数据质量、对土著数据主权的遵守情况以及提供慢性病见解的能力。根据电子邮件访谈和公开信息,对照该框架对数据集进行了评估。结果 我们确定了七个数据集。只有两个数据集报告了慢性疾病,在全国范围内收集了数据,并采集了大量原住民和托雷斯海峡岛民患者的数据。没有一个数据集同时采集了大量主流全科诊所和原住民社区控制健康组织的数据。结论 收集更准确、更全面、更具有文化意义的土著居民和托雷斯海峡岛民医疗保健数据至关重要。这些改进必须以土著数据主权和治理原则为指导。必须为土著居民和托雷斯海峡岛民制定经过验证的适当慢性病指标,包括健康的社会和文化决定因素指标。
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Measuring what counts in Aboriginal and Torres Strait Islander care: a review of general practice datasets available for assessing chronic disease care.

Background Large datasets exist in Australia that make de-identified primary healthcare data extracted from clinical information systems available for research use. This study reviews these datasets for their capacity to provide insight into chronic disease care for Aboriginal and Torres Strait Islander peoples, and the extent to which the principles of Indigenous Data Sovereignty are reflected in data collection and governance arrangements. Methods Datasets were included if they collect primary healthcare clinical information system data, collect data nationally, and capture Aboriginal and Torres Strait Islander peoples. We searched PubMed and the public Internet for data providers meeting the inclusion criteria. We developed a framework to assess data providers across domains, including representativeness, usability, data quality, adherence with Indigenous Data Sovereignty and their capacity to provide insights into chronic disease. Datasets were assessed against the framework based on email interviews and publicly available information. Results We identified seven datasets. Only two datasets reported on chronic disease, collected data nationally and captured a substantial number of Aboriginal and Torres Strait Islander patients. No dataset was identified that captured a significant number of both mainstream general practice clinics and Aboriginal Community Controlled Health Organisations. Conclusions It is critical that more accurate, comprehensive and culturally meaningful Aboriginal and Torres Strait Islander healthcare data are collected. These improvements must be guided by the principles of Indigenous Data Sovereignty and Governance. Validated and appropriate chronic disease indicators for Aboriginal and Torres Strait Islander peoples must be developed, including indicators of social and cultural determinants of health.

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