Third International Conference on System Science in Health Care: Troisième Conférence Internationale sur la Science des Systèmes dans le Domaine de la Santé

1443 Pages·1984·35.52 MB·English-French

by  Charles D. Flagle (auth.), Wilhelm van Eimeren, Rolf Engelbrecht, Charles D. Flagle (eds.)

HEALTH SYSTEMS RESEARCH
Edited by K Davis and W van Eimeren
Third International Conference on
System Science in
Health Care
Troisieme Conference Internationale
sur la Science des Systemes dans Ie Domaine
de laSante
Edited by
W. van Eimeren, R. Engelbrecht, and Ch. D. Flagle
Springer-Verlag
Berlin Heidelberg New York Tokyo 1984
Wilhelm van Eimeren
Rolf Engelbrecht
Gesellschaft fUr Strahl en-
und Umweltforschung mbH Miinchen
MEDIS - Institut fUr Medizinische
Informatik und Systemforschung
Ingolstadter LandstraBe 1
8042 OberschleiBheim, FR Germany
Charles D. Flagle
The Johns Hopkins University
615 North Wolfe Street
Baltimore, Maryland 21205, USA
Third International Conference on System Science in Health Care
Munich, July 16th-20th 1984
ISBN-13: 978-3-642-69941-2 e-ISBN-13: 978-3-642-69939-9
DOl: 10.1007/978-3-642-69939-9
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© Springer-Verlag Berlin Heidelberg 1984
Softcover reprint of the hardcover ist edition 1984
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Preface
In the early stages of planning the Third International Conference in
System Science in Health Care, the steering committee members, most
of whom had participated in the first conference in Paris (1976) and the
second in Montreal (1980), made some basic decisions about organization
of subject matter.
The earlier meetings had been very successful in bringing together
specialists from the health professions and the traditional sciences. In
addition to physicians and nurses, these were representatives of the
disciplines of the behavioral sciences, system theory, economics,
engineering, and the emergency fields of management science and
informatics -all concerned with the development of health resources in a
broad system context.
The reported research and experience of the many disciplines
represented had dealt with one or more of three concerns:
1) a major health problem, such as cardiovascular disease, or an
important popUlation at risk, such as the elderly or children or
workers;
2) some generic aspect of organization and decision making, including
trial and evaluation ofinnovative health strategies; and
3) the methodology of research and analysis in system of health
service. The challenge to the conference organizers lay in the
eliciting and arranging of experiences in such a way that the health
services could be seen as purposeful,living, evolving systems.
The written proceedings of an international conference cannot hope to
capture all the flavor of the exchanges that take place during a week of
intensive professional and social activities. Nevertheless, after the
echoes of the meetings die away, the collected papers remain as the most
tangible and accessible evidence of the substance of the conference; and
the proceedings have a value in their own right, as a cross section - a
snapshot -of the scope of the analysis and the dynamics of development
of health care systems evolving around the world.
For much conscientious effort in preparing the conference and the papers
for publication the Editors are indebted to Brigitte Scholz for organizing
the secretariate, for text processing Ellen Reinhard, Alfred Breier, Janet
Flagle, Ulrike Goldemund, Janina Hofmann and Monika Rauen, and for
computer processing Gunther Klementz and Walter HuB.
We would also like to extend our gratitude to all our colleagues who have
been helping us as well.
Wilhelm van Eimeren Rolf Engelbrecht Charles D. Flagle
Table of Contents
KEYNOTES
Rationale for an International Conference on System Science in
Health Care
Flagle Ch.D., U.S.A ...... 2
Information Systems in Primary Health Care
AndersonJ., United Kingdom ..... 6
Systems Modeling
Rising E.J., U.S.A. ..... 11
Occupational Health: An International Overview (Summary)
EI Batawi M., Switzerland(WHO) ..... 15
Maternal and Child Health
Koizumi A., Japan ..... 19
Manpower Planning in Health Care: An Economists Perspective
Zweifel P., Switzerland ..... 22
Resource Planning
Gibbs R.J., United Kingdom ..... 30
Long Term Planning: The Alternative Futures Approach
Goldschmidt P.G., U.S.A ...... 33
EPIDEMIOLOGY OF CARDIOVASCULAR DISEASES
An Epidemiological Model for Coronary Heart Disease (CHD)
WolfH.K., Gregor R.D., MacKenzie R.B., Rautaharju P.M., Canada ..... 40
Estimation of Cardiovascular Diseases Morbidity
Using Mortality Data
Verdecchia A., Capocaccia R., Mariotti S., Italy ..... 44
Influence of Risk Factors and of Risk Factor Trends on Coronary
Heart Disease Incidence in North and South European Cohorts
Mariotti S., Capocaccia R., Farchi G., Menotti A., Verdecchia A., Italy ..... 48
A Classification of Primary Hypertension for Use in Rehabilitation
Administration and Research
Thurmayr R., Stieber J., Habel W., PotthoffP., Klementz G., F.R.Germany ..... 52
VIII
A Comparative Study of Determining Risk Factors
Bekessy A., Csukas M., Kramli A., Soltesz J., Hungary ..... 56
Prevalence of Hypertension in an Industrial City of Catalonia, Spain
Pardell H., GasullaJ.M., Armario P., Hernandez R., VillalhiJ.R., Coho E., Spain .. 59
The Social Epidemiology of Alcohol Related Hypertension
Martinez R.M., Spain, McQueen D. V., UK, Celentano D.O., U.S.A ...... 61
MEDICAL DECISION MAKING
IN CARDIOVASCULAR DISEASES
Towards Improved Prediction of Coronary Heart Disease
MichaelisJ., F.R.Germany ..... 68
Resumption of Employment Following Myocardial Infarction
Stewart M., Gregor F., Canada ..... 72
Collaborative Study on Tolerance of Antihypertensive Drugs
Cooperative Group ETMA, (Peris-Arso A.), Spain ..... 78
Rational Strategy for Computer based Improved Detection
and Care of Hypertension and other Cardiovascular Risk
Factors in Primary Health Care
Westerman R.F., Hasman A., SchoutenJ.A., KwakmanJ.V.i.,
Guyt H.J.M., Netherlands ..... 80
MANAGEMENT OF CARDIOVASCULAR DISEASES
Evaluation de l'h6pital de jour en hypertension arterielle.
Resultat d'une etude contr6llee
Chatellier G., Devries C., Degoulet P., Ducrocq M.-B., Plouin P.-F.,
Menard J., France ..... 86
Illness-specific Costs of Medical Care and the Problem of
Multimorbidity: The Case of Hypertension
JohnJ., PotthoffP., Schwefel D., F.R.Germany ..... 90
The Frequency of Blood Pressure Measurements in the
Community During an Intensified Hypertension Programme
Piha T., Nissinen A., Tuomilehto.l., Puska P., Finland ..... 94
HEALTH POLICY ANALYSIS
FOR CARDIOVASCULAR DISEASES
Policy Analysis in Hypertension Management: A Synopsis
Heidenherger K., F.R.Germany ..... 100
Cost-effectiveness of Coronary Artery Bypass Graft Surgery
in the Netherlands: Measurements of Effects
Ament A., van Arkel W.G., Heemels G.G.M., Netherlands ..... 104
IX
RISK FACTORS IN SUBSTANCE ABUSE
Drinking Patterns among U rban Women
McQueen D.V., United Kingdom, Celentano D., U.S.A ....... 108
Life Styles and Drinking Behavior among Urban Women
Celentano D., U.S.A, McQueen D.V., United Kingdom ..... 112
Youth and Drugs in Egypt: An Epidemiological Study
SoueifM.I., Darweesh Z.A., Egypt ..... 116
Rehabilitation of Skid-Row Alcoholics without Restricting
the Availability of Alcohol
Kiihlhorn E., Sweden ..... 120
PLANNING AND MANAGEMENT
OF MENTAL HEALTH SERVICES
Developpement et validation d'un instrument d'evaluation des
besoins desjeunes et de leur famille en sante mentale
Toupin J., Mercier H., Tilquin C., Canada ..... 124
OfTre de soins et consommation psychiatrique
SabatiniJ., Paris C., HochmannJ., France ..... 129
A Multi-Period Re~ource Planning Model for a Rehabilitation System
SheffetA.M., KakumanuP.V., U.S.A ...... 133
System Approaches to Mental Health:
San Diego County, California, U.S.A.
Harari H., Bach P.B., U.S.A ...... 137
A Computer Simulation of a Mental Health Service System
HoernerJ.V.Jr., U.S.A ...... 141
a:
The Components of Knowledge-Based Strategy to Decrease
the Frequency of Suicidal Behaviours
Tanney B.L., Ramsay RF., Canada. .... 146
A Community Approach to the Treatment of the
Chronically Mentally III
GJickenM.D., MannJ.B., U.S.A ...... 150
Evaluation of Mental Health Services in Italy
on the Basis of Case Register Studies
Marinoni A., Torre E., Italy ..... 154
RISK FACTORS IN MENTAL HEALTH
Evaluation of Risk Factors for Neurological Disease
and Mental Retardation in a Prospective Cohort-Study
von Wendt L., Rantakallio P., Finland ..... 160
x
Interpretation du rapport du patient schizophrene
a l'institution psychiatrique
Ansermet F., Foster D., Sorrentino M. G., Switzerland ..... 164
Physical Health and Mental Well-Being of Unemployed
-Results of a Longitudinal Survey in the Federal Republic of Germany
Brinkmann C., F.R.Germany ..... 168
The Role of Life Events in Psychosocial Risk Constellations
-Analyzed by Event-History Approaches
Dittmann K.H., Matschinger H., F.R.Germany ..... 172
CULTURAL ASPECTS IN CARE OF THE ELDERLY
Professional Decision Making in Health and Social Care Systems
for the Elderly: A Cross Cultural Comparison
Dussuyer I., RiondetJ., France ..... 178
Nouveaux developpements dans l'organisation de la geriatrie
en Belgique
Baeyens J.-P., Belgium ..... 180
Study of Old Age Health Problems in a Rural Area of Delhi
Aggarwal O.P., Kannan A.T., Indrayan A., Gupta P., Grover V., India ..... 184
Does the Family Care?
-The Role of the Family in Elderly Care in Sweden
Johansson L., Thorslund M., Sweden ..... 188
POLICY ANALYSIS AND PLANNING
OF (LONG TERM) CARE FOR THE ELDERLY
La systematisation des procedures d'admission des personnes agees
dans les etablissements et les programmes de soins et
services intermediaires et a domicile
Tilquin C., Vanderstraeten G., Fournier J., St-Onge E., Toupin J.,
Lambert P., Canada ..... 194
Strategies for Assessing and Monitoring Appropriate Long Term Care
for Elderly People
Boldy D.P., Rhys-Hearn C., Australia ..... 199
Alternative Structures to Institutions for the Provision of Social
and Medical Care: A Study on the Economic and Social Opportunity
of Keeping Old People at Home
Gadreau M., Lemery B., France ..... 203
Planning Services for the Elderly with a Data Bank
on Services Requirement
Beland F., Canada ..... 206
Health Planning for the Elderly: Computer-Assisted Planning
Davis K., U.S.A ...... 209
XI
The Sundsvall Project -A Swedish Action Research Program
for Improved Utilization of Resources in Elderly Care
Thorslund M., Johansson L., Sweden ..... 212
MENTAL HEALTH PROBLEMS OF THE ELDERLY
Confusion in the Older Adult: A Needs-Based Assessment Tool
Murphy M., Perry J.A., Starr M.D., Canada ..... 216
Patterns of Psychiatric Hospitalization of the Elderly Psychotic:
A Canadian Experience
Pablo R Y., Kadlec K., Arboleda-Florez J., Canada ..... 220
Sheltered Housing for the Elderly Chronically Mentally TIl
Christman Mandernach, R, MannJ.B., U.S.A. ..... 226
ASSESSMENT OF THE IMPAIRED ELDERLY
Assessment of the Cognitively Impaired Homebound Elderly:
A Tool for Health Care Providers for Strategic Care Planning
LeNavenec C., Canada ..... 230
La dependance, nouveau type d'information pour la gestion
des etablissements de long sejour
Pors A. , France ..... 234
Assessment of the Dependency Level of Chronic Elderly Patients.
Development and Use of a New Tool in Nursing Homes of the
Canton ofVaud, Switzerland
MartinJ., GrolimundJ.-P., Lehmann Ph., Switzerland ..... 237
Le systeme de mesure de l'autonomie fonctionnelle:
Description d'un instrument d'evaluation des handicaps
Hebert R., Carrier R., Bilodeau A., Canada ..... 241
Le systeme de mesure de l'autonomie fonctionnelle:
Etude de Validation
Hebert R, Bilodeau A., Carrier R., Canada ..... 245
PREVENTIVE APPROACHES ·TO CARE
OF THE ELDERLY
Experiments in Preventive Care of the Elderly and their Evaluation
Holstein B.E., Denmark (WHO) ..... 250
Approaches to Screening and Case-Finding in Elderly Populations
Taylor R.,BarberJ.H., United Kingdom ..... 254
Problems in Measuring the Functioning of the Elderly:
Historical Review of Functional Assessments (1940-1978)
Hermanova H., Denmark WHO ..... 258
XII
Planification et gestion rationnelles en tant qu'approches
preventives dans un systeme de soins et services pour les
personnes !gees: une etude de cas
Tilquin c., Vanderstraeten G., Blain G., FournierJ., Canada ..... 265
EPIDEMIOLOGY OF OCCUPATIONAL HEALTH
Type A Behavior as a Moderator of Job Stress and Outcome Relationship
Jamal M., Canada ..... 272
The Importance of Medical Risks and Working Conditions as
Determinants of Rheumatic Diseases
Karmaus W., F.R.Germany ..... 276
Subjective Description and "Objective" Classification ofJ obs in
Relation to Blood Pressure Level and Blood Pressure Variations
Knox S., Theorell T., SvenssonJ., Waller D., Sweden ..... 280
Role de l'environnement social et du milieu de travail
sur l'hypertension arterielle et son traitement -etu,de de 7683 sujets
LangT., Degoulet P., Fouriaud C., Jacquinet-Salord M.C., Aime F.,
Laprugne J., Main J., Oeconomos J., Phalente J., Prades A., France ..... 286
Une Methodologie pour l'appreciation des risques d'accident
dans les ateliers etlou sur les chant iers
Zighed A., Dussauchoy A., France. . . .. 290
OCCUPATIONAL HEALTH MANAGEMENT
Epidemiological Uses of an Occupational Health Information System
Gunderson E.K., U.S.A ..... 294
The Use of Epidemiological Models in Planning
Preventive Programmes in Occupational Health
Phillips M.R., Australia ..... 298
T!che complexe simulee et vigilance
Amphoux M., Sauvignon M., Ignazi G., France ..... 302
Reinsertion sociale des handicapes physiques:
Resultat d'etudes systemiques
Coblentz A., Ignazi G., Prudent J., Amphoux M., France. . . .. 306
ENVIRONMENTAL RISK FACTORS
An Analytical Treatment of Potential Hazard and Risk Assessment
for Environmental Chemicals
Gottinger H.W., F.R.Germany ..... 312
Air Pollution in Bavaria -A Pilot Study with a Random Sample of
Physicians in Ambulatory Care
Kellhammer U., F.R.Germany ..... 314