Starodubov V.I.¹, Rudnev S.G.^2,1, Nikolaev D.V.^3,1, Korostylev K.A.^3,1
1Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow
²Institute of Numerical Mathematics of the Russian Academy of Sciences, Moscow
³Scientific Research Centre ‘Medass’, Moscow

Contacts: Sergey G. Rudnev, This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Abstract.

Background. Currently, the Federal Information Resource of Health Centres is the only source of mass in-depth data of preventive screening in Russia.

The study purpose was to characterize current state of the Resource and to address the organizational and methodological problems in the data collection system and develop possible ways for improvement.

Material and methods. The Federal Information Resource of Health Centres database as of July, 2014, was combined with the submitted data according to the letter from the Ministry of Health of the Russian Federation ¹24-4/10/2-8914 as of November 26, 2014. Age, gender and geographic distributions of the total number of Health Centres’ visitors were estimated. Total data in the database was compared with the official statistics of Health Centres’ attendance, and the causes of the observed differences were analyzed.

Results. As of May 2015, the Federal Information Resource of Health Centres database contained raw data of measurements of 3.72 million people (2.6% of the Russian population). The number of registered visits in the database was 4.78 million (or about 25% of the total number of visits to Health Centres, according to the official data). In the age structure of visitors, children and adolescents of school age, and also women aged from 50 to 65 years, prevailed.

Adult, especially male, population of working age was under-represented.

In 27 Federal Subjects of the Russian Federation, the number of visits exceeded 3% of the regional population. Data from 31 Federal Subjects were not presented in the database.

The authors identified the following reasons of non-provision of complete data to the database (in descending order of importance):

• In violation of the letter of the Health Ministry ¹29-5/10/2-4339 as of May 3, 2011, the Regional Information Resource of Health Centres was neither created nor functioning in the Federal Subject of the Russian Federation;
• The Health Centre did not use the functional component ‘Health Centre’. Instead, another software was utilized not ensuring interaction with the Federal database;
• The Health Centre used an equipment not compatible with the ‘Health Centre’ functional component;
• Loss of data due to a PC damage or computer virus attack;
• The ‘Health Centre’ functional component needs improvement with due regard to regional peculiarity of the Health Centres’ financing;
• Health care facility where the Centre is based lacks IT staff to install the functional component ‘Health Centre’ software program;
• The Health Centre lacks access to the Internet.

Discussion. At present, the Form 68 of the Sectoral Statistical Observation ‘Information on the Health Centres function’ is generated by the Russian Federal Subjects on the basis of monthly reports from Health Centres, and not allow for direct validity check. At the same time, the Health Centres activities are reimbursed on the basis of planned attendance. In case of insufficient attendance or inadequate plan, this can result in attempts to over-report the attendance leading to decreased data quality. According to our preliminary estimates, the proportion of incorrect data in the Federal Information Resource of Health Centres database, including fake data, averaged 30% and varied greatly depending on the region, the Health Centre, and the year of examination. Therefore, any objective epidemiological research on the basis of the Health Centres data should be accompanied by a critical analysis of the entire array of raw data, formation of the selection criteria, search and deletion of data artifacts.

Conclusions. 1) It is necessary to change the way the Form 68 of the Sectoral Statistical Observation ‘Information on the Health Centres function’ is generated: it should be generated at the federal rather than regional level, based on processing and analysis of data of the Federal Information Resource of Health Centres.

2) The priority measures aimed to address the identified problems in the data collection system should include the following:

• To resume state support of the Federal Information Resource of Health Centres;
• To set up/resume activities of the Regional Information Resource of Health Centres in those Federal Subjects of the Russian Federation where it was not functioning;
• To ensure a large-scale implementation of the functional component ‘Health Centre’;
• The revise the functional component ‘Health Centre’ with due regard to the regional peculiarity of the Health Centres financing;
• To urgently equip Health Centres with devices compatible with the functional component ‘Health Centre’;
• To integrate the already installed equipment with the functional component ‘Health Centre’.

3) Due to low attendance of Health Centres by the working population it is advisable to include Health Centres in the program of the 1st stage of the Russian adult population prophylactic medical examination.

4) It is advisable to incorporate the Federal Information Resource of Health Centres into the structure of the Russian Unified State Health Information System.

Keywords: Health Centres; software package ‘Health Centre’; Federal Information Resource of Health Centres; automated data collection; preventive screening.

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