The limited amount of evidence available from mortality statistics, mental hospital in-patient admission rates and community surveys appears to indicate that people of African-Caribbean origin resident in Britain have fewer alcohol-related problems than the white population. However, there are no systematic data on the normal drinking habits of random and representative samples of the black population of Britain, or the true extent of alcohol-related problems in the whole population. A survey of the drinking habits and alcohol-related problems of random samples of 200 black men and 170 white men from the Birmingham and Wolverhampton areas is reported. Black men were much less likely to report regular drinking and to report drinking large amounts of alcohol. They were far less likely to have got drunk in the past year, and scored lower on most items of an Alcohol Problems Scale. Age was the only demographic variable associated with drinking levels in both groups, and the link was more tenuous in the black than the white group. There were no generational differences found. Religious observance and belonging to a Pentecostal Church were found to be major differences between the black and white groups, and strongly associated with moderation in relation to alcohol.
Objectives: To evaluate the impact of electronic health record (EHR)
interoperability on the quality of immunization data in the North Dakota
Immunization Information System (NDIIS). Methods: NDIIS doses
administered data was evaluated for completeness of the patient and
dose-level core data elements for records that belong to interoperable and
non-interoperable providers. Data was compared at three months prior to
electronic health record (EHR) interoperability enhancement to data at
three, six, nine and twelve months post-enhancement following the
interoperability go live date. Doses administered per month and by age
group, timeliness of vaccine entry and the number of duplicate clients added
to the NDIIS was also compared, in addition to, immunization rates for
children 19 – 35 months of age and adolescents 11 – 18 years
of age. Results: Doses administered by both interoperable and
non-interoperable providers remained fairly consistent from pre-enhancement
through twelve months post-enhancement. Comparing immunization rates for
infants and adolescents, interoperable providers had higher rates both pre-
and post-enhancement than non-interoperable providers for all vaccines and
vaccine series assessed. The overall percentage of doses entered into the
NDIIS within one month of administration varied slightly between
interoperable and non-interoperable providers; however, there were
significant changes between the percentage of doses entered within one day
and within one week with the percentage entered within one day increasing
and within one week decreasing with interoperability. The number of
duplicate client records created by interoperable providers increased from
94 duplicates pre-enhancement to 10,552 at twelve months post-enhancement,
while the duplicates from non-interoperable providers only increased from
300 to 637 over the same period. Of the 40 core data elements in the NDIIS,
there was some difference in completeness between the interoperable versus
non-interoperable providers. Only middle name, sex, county, phone number,
mother’s maiden name, vaccine manufacturer, lot number and expiration
date were significantly (>=5%) different between the two provider
groups. Conclusions: Interoperability with provider EHRs has
had an impact on NDIIS data quality. Timeliness of data entry has improved
and overall doses administered have remained fairly consistent, as have the
immunization rates for the providers assessed. There are more technical and
non-technical interventions that will need to be accomplished by NDIIS staff
and vendor to help reduce the negative impact of duplicate record
creation, as well as, data completeness.
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