Analysis of the impact of social determinants and primary care morbidity on population health outcomes by combining big data: A research protocol.

big data electronic health records—HER morbidity social determinants of health (MeSH) socioeconomic factors (MeSH)

Journal

Frontiers in medicine
ISSN: 2296-858X
Titre abrégé: Front Med (Lausanne)
Pays: Switzerland
ID NLM: 101648047

Informations de publication

Date de publication:
2022
Historique:
received: 05 08 2022
accepted: 01 12 2022
entrez: 2 1 2023
pubmed: 3 1 2023
medline: 3 1 2023
Statut: epublish

Résumé

In recent years, different tools have been developed to facilitate analysis of social determinants of health (SDH) and apply this to health policy. The possibility of generating predictive models of health outcomes which combine a wide range of socioeconomic indicators with health problems is an approach that is receiving increasing attention. Our objectives are twofold: (1) to predict population health outcomes measured as hospital morbidity, taking primary care (PC) morbidity adjusted for SDH as predictors; and (2) to analyze the geographic variability of the impact of SDH-adjusted PC morbidity on hospital morbidity, by combining data sourced from electronic health records and selected operations of the National Statistics Institute ( The following will be conducted: a qualitative study to select socio-health indicators using RAND methodology in accordance with SDH frameworks, based on indicators published by the To achieve the first objective, predictive models will be used, with a test-and-training technique, fitting multiple logistic regression models. In the analysis of geographic variability, penalized mixed models will be used, with geographic units considered as random effects and independent predictors as fixed effects. This study seeks to show the relationship between SDH and population health, and the geographic differences determined by such determinants. The main limitations are posed by the collection of data for healthcare as opposed to research purposes, and the time lag between collection and publication of data, sampling errors and missing data in registries and surveys. The main strength lies in the project's multidisciplinary nature (family medicine, pediatrics, public health, nursing, psychology, engineering, geography).

Sections du résumé

Background UNASSIGNED
In recent years, different tools have been developed to facilitate analysis of social determinants of health (SDH) and apply this to health policy. The possibility of generating predictive models of health outcomes which combine a wide range of socioeconomic indicators with health problems is an approach that is receiving increasing attention. Our objectives are twofold: (1) to predict population health outcomes measured as hospital morbidity, taking primary care (PC) morbidity adjusted for SDH as predictors; and (2) to analyze the geographic variability of the impact of SDH-adjusted PC morbidity on hospital morbidity, by combining data sourced from electronic health records and selected operations of the National Statistics Institute (
Methods UNASSIGNED
The following will be conducted: a qualitative study to select socio-health indicators using RAND methodology in accordance with SDH frameworks, based on indicators published by the
Analysis UNASSIGNED
To achieve the first objective, predictive models will be used, with a test-and-training technique, fitting multiple logistic regression models. In the analysis of geographic variability, penalized mixed models will be used, with geographic units considered as random effects and independent predictors as fixed effects.
Discussion UNASSIGNED
This study seeks to show the relationship between SDH and population health, and the geographic differences determined by such determinants. The main limitations are posed by the collection of data for healthcare as opposed to research purposes, and the time lag between collection and publication of data, sampling errors and missing data in registries and surveys. The main strength lies in the project's multidisciplinary nature (family medicine, pediatrics, public health, nursing, psychology, engineering, geography).

Identifiants

pubmed: 36590942
doi: 10.3389/fmed.2022.1012437
pmc: PMC9800778
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1012437

Informations de copyright

Copyright © 2022 Couso-Viana, Bentué-Martínez, Delgado-Martín, Cabeza-Irigoyen, León-Latre, Concheiro-Guisán, Rodríguez-Álvarez, Román-Rodríguez, Roca-Pardiñas, Zúñiga-Antón, García-Flaquer, Pericàs-Pulido, Sánchez-Recio, González-Álvarez, Rodríguez-Pastoriza, Gómez-Gómez, Motrico, Jiménez-Murillo, Rabanaque and Clavería.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Références

Eur J Gen Pract. 2009 Dec;15(4):243-50
pubmed: 20055723
Gac Sanit. 2012 Mar;26 Suppl 1:76-81
pubmed: 22047623
Lancet. 2002 Nov 23;360(9346):1640-5
pubmed: 12457787
Springerplus. 2013 Dec;2(1):51
pubmed: 23450738
BMC Public Health. 2008 Feb 20;8:66
pubmed: 18284701
Front Public Health. 2020 Sep 22;8:457
pubmed: 33072683
J Urban Health. 2018 Oct;95(5):647-661
pubmed: 29039133
Gac Sanit. 2021 Mar-Apr;35(2):113-122
pubmed: 32014314
Gac Sanit. 2012 Mar;26 Suppl 1:88-93
pubmed: 22321944
Pediatrics. 2019 Oct;144(4):
pubmed: 31548335
BMC Med Res Methodol. 2003 Oct 20;3:21
pubmed: 14567763
Rev Esp Salud Publica. 2007 Jan-Feb;81(1):7-13
pubmed: 17458102
BMC Public Health. 2020 Jun 3;20(1):853
pubmed: 32493328
Palliat Med. 2017 Sep;31(8):684-706
pubmed: 28190381
Gac Sanit. 2016 Nov;30 Suppl 1:38-44
pubmed: 27837795
Fam Pract. 2004 Aug;21(4):381-6
pubmed: 15249526
J Med Internet Res. 2018 May 29;20(5):e185
pubmed: 29844010
Am J Epidemiol. 2005 Aug 1;162(3):199-200
pubmed: 15987728
Health Technol Assess. 1998;2(3):i-iv, 1-88
pubmed: 9561895
JBI Database System Rev Implement Rep. 2018 Feb;16(2):345-384
pubmed: 29419621
Gac Sanit. 2009 Jan-Feb;23(1):29-37
pubmed: 19231720
N Engl J Med. 1998 Jun 25;338(26):1918-20
pubmed: 9637815
Med Sci Monit. 2019 Mar 17;25:1994-2001
pubmed: 30879019
Int J Environ Res Public Health. 2021 Jan 30;18(3):
pubmed: 33573323
Gac Sanit. 2012 Mar-Apr;26(2):182-9
pubmed: 22112713
J Epidemiol Community Health. 2017 Jun;71(6):565-575
pubmed: 27682963
Lancet Psychiatry. 2018 Apr;5(4):357-369
pubmed: 29580610

Auteurs

Sabela Couso-Viana (S)

I-Saúde Group, South Galicia Health Research Institute (Instituto de Investigación Sanitaria Galicia Sur), SERGAS-UVIGO, Vigo, Spain.

Carmen Bentué-Martínez (C)

Department of Geography, Aragon University Environmental Sciences Research Institute (Instituto Universitario de Investigación en Ciencias Ambientales de Aragón/IUCA), University of Zaragoza, Zaragoza, Spain.

María Victoria Delgado-Martín (MV)

I-Saúde Group, South Galicia Health Research Institute (Instituto de Investigación Sanitaria Galicia Sur), SERGAS-UVIGO, Vigo, Spain.
Moaña Health Center, Vigo Area, SERGAS, Vigo, Spain.

Elena Cabeza-Irigoyen (E)

Health Promotion Service, Ministry of Health and Consumer Affairs, Public Health Research Group (Grup d'Investigació en Salud Pública/GISPIB), Balearic Islands Health Research Institute (IdISBa), Balearic Islands, Spain.

Montserrat León-Latre (M)

La Jota Health Center, Aragonese Health Service, Aragon, Spain.

Ana Concheiro-Guisán (A)

Department of Pediatrics, Álvaro Cunqueiro Hospital, SERGAS, Vigo, Spain.
Rare Diseases and Pediatric Medicine Group, South Galicia Health Research Institute (Instituto de Investigación Sanitaria Galicia Sur), SERGAS-UVIGO, Vigo, Spain.

María Xosé Rodríguez-Álvarez (MX)

Department of Statistics and Operations Research, Biomedical Research Center (Centro de Investigacións Biomédicas/CINBIO), University of Vigo, Vigo, Spain.
Galician Research and Mathematical Technology Center (Centro de Investigación e Tecnoloxía Matemática de Galicia/CITMAga), Vigo, Spain.

Miguel Román-Rodríguez (M)

Primary Care Management of Mallorca, Balearic Islands Health Research Institute, Balearic Islands, Spain.

Javier Roca-Pardiñas (J)

Galician Research and Mathematical Technology Center (Centro de Investigación e Tecnoloxía Matemática de Galicia/CITMAga), Vigo, Spain.
Department of Statistics and Operations Research, University of Vigo, Vigo, Spain.
Network for Research on Chronicity, Primary Care and Health Promotion (Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud/RICAPPS), Galicia, Spain.

María Zúñiga-Antón (M)

Department of Geography, Aragon University Environmental Sciences Research Institute (Instituto Universitario de Investigación en Ciencias Ambientales de Aragón/IUCA), University of Zaragoza, Zaragoza, Spain.

Ana García-Flaquer (A)

Balearic Islands Health Research Platform (Plataforma de Investigación en Información en Salud de Las Islas Baleares/PRISIB), Balearic Islands, Spain.

Pau Pericàs-Pulido (P)

Balearic Islands Health Research Platform (Plataforma de Investigación en Información en Salud de Las Islas Baleares/PRISIB), Balearic Islands, Spain.

Raquel Sánchez-Recio (R)

Aragon Health Services Research Group (Grupo de Investigación en Servicios Sanitarios de Aragón/GRISSA), Aragon, Spain.
Aragonese Institute of Health, Aragon, Spain.

Beatriz González-Álvarez (B)

Aragonese Institute of Health, Aragon, Spain.

Sara Rodríguez-Pastoriza (S)

I-Saúde Group, South Galicia Health Research Institute (Instituto de Investigación Sanitaria Galicia Sur), SERGAS-UVIGO, Vigo, Spain.

Irene Gómez-Gómez (I)

Network for Research on Chronicity, Primary Care and Health Promotion (Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud/RICAPPS), Galicia, Spain.
Department of Psychology, Loyola University Andalusia, Seville, Spain.

Emma Motrico (E)

Network for Research on Chronicity, Primary Care and Health Promotion (Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud/RICAPPS), Galicia, Spain.
Department of Psychology, Loyola University Andalusia, Seville, Spain.

José Luís Jiménez-Murillo (JL)

Technical Sub-directorate for Information Management, Andalusian Health Service, Seville, Spain.

Isabel Rabanaque (I)

Department of Geography, Aragon University Environmental Sciences Research Institute (Instituto Universitario de Investigación en Ciencias Ambientales de Aragón/IUCA), University of Zaragoza, Zaragoza, Spain.

Ana Clavería (A)

I-Saúde Group, South Galicia Health Research Institute (Instituto de Investigación Sanitaria Galicia Sur), SERGAS-UVIGO, Vigo, Spain.
Network for Research on Chronicity, Primary Care and Health Promotion (Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud/RICAPPS), Galicia, Spain.

Classifications MeSH