National Identification Number Research Articles

Variation in disease in children according to immigrant background.

A growing proportion of children born in Europe are born to immigrant parents. Knowledge about their health is essential for preventive and curative medicine and health services planning. To investigate differences in diagnoses given in secondary and tertiary healthcare between Norwegian-born children to immigrant and non-immigrant parents. Data from the Medical Birth Registry of Norway, the Norwegian Patient Registry and Statistics Norway were linked by the national personal identification number. The study population included children born in Norway aged 0-10 years between 2008 and 2018 (N=1,015,267). Diagnostic categories from three main domains of physical health, given in secondary or tertiary care; infections, non-infectious medical conditions and non-infectious neurological conditions were included from 2008 onwards. Hazards of diagnoses by immigrant background were assessed by Cox regressions adjusted for sex and birth year. Children of immigrants generally had higher hazards than children with Norwegian background of some types of infections, obesity, nutrition-related disorders, skin diseases, blood disease and genital disease. Children of immigrants from Africa also had higher hazards of cerebral palsy, cerebrovascular diseases and epilepsy. Conversely, most groups of children of immigrants had lower hazards of acute lower respiratory tract infections, infections of the musculoskeletal system, infections of the central nervous system, diseases of the circulatory system, hearing impairment, immune system disorders, chronic lower respiratory disease and headache conditions. Children of immigrants did not present with overall worse health than children without immigrant background, but the distribution of health problems varied between groups.

Implementation of a National Identity Number-Based Identity Card Policy In Pasangkayu Regency

The policy development mechanism for the national identity number -based electronic ID card software is described in this report. In this analysis, a qualitative procedure was used in conjunction with a case study technique. The total number of informants was 19. Employees from the government who work on the national identity number -based electronic identification card software make up this group. The culture is often used as a source of information in this report. The findings of the study indicate that; Every organ and implementor personnel at every level in every Pasangkayu sub-district office understands and implements national Identity Number -based electronic identification card policy requirements and goals, namely: first, citizens with a identification card condition have the right to get a electronic identification card, which the government is required to promote. Second, get closer to the position where the community resides, in this case the office respective districts, such that the community is not inconvenienced and burdened, must go to the Disdukcapil office in the district capital. Third, since these programs are provided free of charge or at no expense to government, this approach would not impose an economic burden. Fourth, this proposal has little effect on the district's spending schedule. As a result, success policy is essentially an evaluation of how well expectations and policy priorities have been met. As a result, the policy's standards and objectives must be practical and specifically targeted, and any implementation entity (implementor) must be aware of the policy's standards and objectives.

MO459RENAL FUNCTION AMONG PATIENTS WITH NEW DIAGNOSIS OF ATRIAL FIBRILLATION - RESULTS FROM THE NATIONWIDE FINACAF- STUDY

Abstract Background and Aims Chronic kidney disease (CKD) is a global public health problem with increasing number of patients due to obesity, hypertension, diabetes, and aging. CKD is an independent risk factor for atrial fibrillation (AF) and the incidence of AF in patients with CKD is two- to threefold higher compared to the general population. Relationship between CKD and AF is bidirectional, and the incidence of impaired renal function is higher in patients with AF. Both AF and CKD are associated with increased risk of stroke and systemic thromboembolism, and also bleeding. The Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) is a nationwide study among AF patients conducted as a retrospective register-based linkage study combining data from several Finnish health care registers. We aimed to characterize demographics and comorbities of AF patients included in FinACAF according to stages of renal function. Method FinACAF- study collects data from 411 000 patients covering all Finnish AF patients from 1 January 2004 to 31 December 2018. Using national unique personal identification number, individual patients’ data from ten nationwide population registries and six regional laboratory databases (∼282 000, 77% of the patients) are linked together. Inclusion criteria of this substudy were all patients who had new ICD-10 AF diagnosis (code I48) between January 2010 and December 2018 and measured estimated glomerular filtration rate (eGFR) within the proximity of AF the diagnosis. Results Of the whole study cohort, 128 538 were included in this substudy. The mean age at the time of AF diagnosis was 73 years (range 18 to 107 years) and 48.9 % of the patients were female. The age of AF patients increased (Figure 1) and eGFR decreased (Figure 2) in various stages of glomerular filtration at the cohort entry during 2010-2018 are shown in Figures 1 and 2. Prevalence of various comorbidities and the mean age at the baseline are shown in the Table. Most of the comorbidities were more common in patients with lower eGFR levels. Conclusion During 2010-2018 the mean age of new AF patients increased in Finland, and simultaneously the renal function decreased. Also, patients with impaired glomerular filtration rate had more often comorbidities increasing the risk of thromboembolism and bleeding. The findings emphasize appropriate control of these risks in AF patients, especially with reduced renal function.

All you want to know about the arrhythmia: A comprehensive, nationwide registry study of atrial fibrillation in Finland

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Helsinki and Uusimaa Hospital District Funding The Finnish Foundation for Cardiovascular Research OnBehalf FinACAF Introduction The number of atrial fibrillation (AF) patients is increasing, and thus, the socio-medico-economic impact of AF is exploding. Up-to-date, multifaceted data about the characteristics of AF patients, their treatments, and outcomes are urgently needed. Purpose The aim of the Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) study is to evaluate the incidence and prevalence of AF, risk of stroke, thromboembolic complications, myocardial infarction, major bleeding events, and mortality in AF patients using comprehensive nationwide registries regulated by law. Assessment of the socio-medico-economic aspects of AF and the effect of socio-economic factors on the AF treatment play a central role in this study. Methods The FinACAF study collects data from 411 000 patients covering all Finnish AF patients from 1st January 2004 to 31st December 2018. Using national unique personal identification number, individual patient data from ten nationwide population registries and six regional laboratory databases (∼282000, 77 % of the patients) are linked together. All the register data were obtained during Q1-Q2/2020. The main results will be expected during Q1-2/2021. Results Since the introduction of the national primary care register in 2012, 9% of all AF patients were identified outside hospital care registers. The total number of AF patients on 31st December 2018 was 227 114, which translates to an AF prevalence of 4.1% in Finland (population of 5 517 900). The Table represents the registries used in the FinACAF study. Conclusions The FinACAF study records all patient contacts with the health care institutions and organizations, as well as incomes and places of domicile. Thus, the database allows a unique possibility to investigate the epidemiology and socio-medico-economic impact of AF as well as the cost effectiveness of different AF management strategies in a completely unselected, nationwide population. This data will markedly help "leading with data" when the increasing number of AF patients are treated. The registries used in the FinACAF study Register Registry Information obtained Finnish Care Register for Health Care: Primary, Hospital and Social care registries National Institute for Health and Welfare Diagnosis (ICD-10), procedure codes and date; non-hospital institutionalizations National Prescription Register, National Reimbursement Register The Social Insurance Institution of Finland Drug purchases (date, ATC codes, amount), Reimbursement decisions for chronic diseases (date, ICD-10) National Causes of Death Register, The Register of Completed Education and Degrees Statistics Finland Deaths and causes of deaths (ICD-10), Education and socio-economic status National Cancer Registry (1st Jan 1950 to 31st Dec 2018) Finnish Cancer Registry National registry of all cancer cases (e.g. date, ICD-O-3, TNM) Population Register, Tax register Population Register Center, Tax Administration Places of domicile, Income and taxes Laboratory databases (1st Jan 2010 to 31st Dec 2018) Six largest regional laboratory databases INR and other relevant laboratory measurements

Registry-Based Study of Prevalence of Cleft Lip/Palate in Thailand from 2012 to 2015.

Two main objectives were established. First objective was to determine the prevalence of the cleft lip and/or cleft palate (CL/P) in Thailand from 2012 to 2015 using the orofacial clefts (OFCs) registry and civil registration. Second objective was to conduct a quality control of this OFC registry especially for the Birth Defects Registration (BDR). Registry-based survey. Analyzing data from the Thailand National Health Security Office. Registered patients with CL/P in Thailand from 2012 to 2015. None. Duplicated records were verified using National Identity Number (Thai ID#) and date of birth. The prevalence of CL/P and specific phenotypes was then calculated. From this prevalence estimate method, quality assurance of the OFCs registry was possible. For the main outcome, the population-weighted pool prevalence of CL/P was 2.14 per 1000 live births (95% confidence interval of 2.08-2.20). Thai ID# and expense reimbursement systems were the main factors driving this cases capturing. However, this OFCs registration still requires active case finding with clinical verification, improvement of staff training and databases networking. This study reported a very high CL/P prevalence of Thailand. Strengths and limitations of these OFCs registry and BDR were described.

Update on technologies, medicines and treatments.

An abstract presented at the 2020 European Association for the Study of Diabetes (EASD) suggests that, in future, we might be able to monitor longer term exposure to glucose through our tears. The study measured glycated albumin (GA) in lacrimal fluid and found this to be strongly correlated to glycated albumin in blood, an indicator of glycaemia over a 2 week period.

Network Authentication Protocol Based on Secure Biometric NIDN

In this paper an authentication based finger print biometric system is proposed with personal identity information of name and birthday. A generation of National Identification Number (NIDN) is proposed in merging of finger print features and the personal identity information to generate the Quick Response code (QR) image that used in access system. In this paper two approaches are dependent, traditional authentication and strong identification with QR and NIDN information. The system shows accuracy of 96.153% with threshold value of 50. The accuracy reaches to 100% when the threshold value goes under 50.

Building a master health facility list: innovative Indian experience

Adoption of information technology in healthcare has in recent years improved the process of information collection, analysis and use in the Indian public health system. However, it has also led...

The Use of Density-Based Spatial Clustering of Application With Noise (DBSCAN) for Record Linkage in An Observational HIV Cohort

IntroductionThe South African HIV Cancer Match (SAM) study is a probabilistic record linkage study involving creation of an HIV cohort from laboratory records from the National Health Laboratory Service (NHLS). This cohort was linked to the pathology based South African National Cancer Registry to establish cancer incidences among HIV positive population in South Africa. As the number of HIV records increases, there is need for more efficient ways of de-duplicating this big-data. In this work, we used clustering to perform big-data deduplication.
 Objectives and ApproachOur objective was to use DBSCAN as clustering algorithm together with bi-gram word analyser to perform big-data deduplication in resource-limited settings. We used HIV related laboratory records from entire South Africa collated in the NHLS Corporate Data Warehouse for period 2004-2014. This involved data pre-processing, deterministic deduplication, ngrams generation, features generation using Term Frequency Inverse Document Frequency vectorizer, clustering using DBSCAN and assigning cluster labels for records that potentially belonged to the same person. We used records with national identification numbers to assess quality of deduplication by calculating precision, recall and f-measure.
 ResultsWe had 51,563,127 HIV related laboratory records. Deterministic deduplication resulted in 20,387,819 patient record deduplicates. With DBSCAN clustering we further reduced this to 14,849,524 patient record clusters. In this final dataset, 3,355,544 (22.60%) patients had negative HIV test, 11,316,937 (76.21%) had evidence for HIV infection, and for 177,043 (1.19%) the HIV status could not be determined. The precision, recall and f-measure based on 1,865,445 records with national identification numbers were 0.96, 0.94 and 0.95, respectively.
 Conclusion / ImplicationsOur study demonstrated that DBSCAN clustering is an effective way of deduplicating big datasets in resource-limited settings. This enabled refining of an HIV observational database by accurately linking test records that potentially belonged to the same person. The methodology creates opportunities for easy data profiling to inform public health decision making.

Analysis of Association between the Consumer Food Quality Perception and Acceptance of Enhanced Meat Products and Novel Packaging in a Population-Based Sample of Polish Consumers.

The consumer acceptance of novel enhanced-quality products and their willingness to buy such products may be a crucial topic in the field of marketing. The aim of this study was to analyze the association between consumers’ perceptions of food quality and their acceptance of enhanced meat products and novel packaging. The study was conducted using the Computer-Assisted Personal Interview (CAPI) method in a random group of 1009 respondents, who were recruited as a representative sample based on data from the Polish National Identification Number database. The participants were asked about the most important quality determinants of food products of animal origin and about quality improvement methods and their acceptance of those methods. The quality determinants of animal-based food products were indicated as follows: origin, production technology, manufacturer, components and nutritional value, visual and sensory characteristics, expiry date, and cost. The quality improvement methods were clustered into groups that were associated with product enhancement and application of novel packaging, and the acceptance of those methods was also verified. Indicating specific quality determinants of animal-derived food products affects the consumer acceptance of product enhancement (p = 0.0264) and novel packaging as quality improvement methods (p = 0.0314). The understanding that enhancement is applied for the purpose of quality improvement did not influence the acceptance of products (p = 0.1582), whereas the knowledge that novel packaging is applied influenced the acceptance (p = 0.0044). The obtained results suggested that in the case of application of novel packaging, a higher level of knowledge may be a reason for consumer’s rejection of the resulting products, but the appearance and taste of products may contribute to the higher acceptance of novel packaging. Educating consumers may improve their acceptance of product enhancement, as concerns about the addition of food preservatives may lead them to reject enhanced products.

Road traffic crash characteristics of drivers who take prescription medicines that carry a risk to driving

BackgroundThe specific features of crashes involving an alcohol-intoxicated driver have been extensively characterized, but no such data are available for crashes involving a driver who has used a prescription medicine, which could help to plan and target prevention and control initiatives. This study aimed to describe the characteristics of crashes involving drivers under the influence of prescription medicines. MethodsWe took advantage of CESIR, a French record linkage study for which data were extracted and matched from three French national databases: police reports, the national police database of injurious crashes and the national health care insurance database (HCI database). The drivers included in the study were those involved in an injurious road crash in France from July 1, 2005 to December 31, 2015, whose national identity number, date of birth and sex allowed matching. Prescription medicines considered were those with the two highest levels of warning. ResultsSimilar crash profiles were found when drivers used alcohol or medicines, particularly with respect to injury severity, type of vehicle, type of collision, type of road and cross-track profile. Alcohol-related crashes were over-represented during weekends and in low-density areas and medicine-related crashes were over-represented during weekdays and in cities of fewer than 300 000 inhabitants. While a much higher strength of association with responsibility was found for alcohol than for medicines, the proportion of crashes with drivers using medicines was twice as high as crashes with drivers using alcohol. ConclusionThe lower risk carried by medicines is therefore in part compensated by a higher prevalence of use, making medicines one of the hidden factors of road risk. Characterizing these crashes will therefore be useful to better focus road safety intervention on the prevention of driving under the influence of psychotropic medicines.

Opportunities for the Application of City Government Policies in Implementing Motor Vehicle and Surface Water Taxes in Indonesia

Transparency in public policy is one pillar of a state democracy. This is important because the community as the implementer of the policy can monitor government performance. Motor vehicle and surface water taxes are the largest revenue sector in the regional budget. Therefore, this study aims to analyze qualitatively about the application of city government policies in implementing motor vehicle and surface water taxes in Indonesia. This study was conducted with an explanatory sequential mixed method design which consisted of two stages, quantitative data collection and qualitative data collection to help decipher quantitative data. This study was conducted in West Java province with 18 regencies and 9 municipalities and the Regional Revenue Agency of West Java which has 34 One-stop Administration Services Offices of Regional Tax Management Center spread in 5 working areas. The research problems include (1) How is the implementation of motor vehicle and surface water tax policies in West Java regencies/Cities? and (2) What is the ideal policy implementation model design for Regencies/Cities in West Java? The results show that the regency/city government has implemented the excavation of motor vehicle and surface water tax potentials through intensification and extensification through regional apparatuses and the policy implementation model design for regencies/cities is the application model of national identity number single ID.

Abstract PR05: Utilizing electronic fertility clinic records and registry linkage to establish a retrospective population-based cohort study to evaluate the association between in vitro fertilization (IVF) and subsequent cancer risk in women

Abstract Background: Since the introduction of in vitro fertilization (IVF) in 1978, the use of assisted reproduction technology (ART) has increased annually with an estimated 240,000 ART-conceived children born each year worldwide. Despite its widespread use, the impact on subsequent maternal and child health is not well understood. Specifically, cancer risk in women receiving IVF treatment has not been adequately evaluated, in part due to the complex nature of the research question and the need for large numbers of exposed women with long follow-up to evaluate rare cancer outcomes. Methods: To address this research question, we designed a country-wide retrospective medical record linkage study that utilizes electronic records from all IVF units in operation in Israel between 1997 and 2014. Linkage to cancer registry is facilitated via unique national identification numbers. We selected Israel for this study because it has the highest rate of ART/IVF exposure in the world, with 24 IVF units in the country that perform more than 45,000 ART cycles annually. Fertility treatment is fully covered by national health insurance with no restriction on the number of cycles or type of procedure, thus reducing potential selection issues related to access to care that may exist in other populations. We are currently collecting medically documented and detailed exposure information from the IVF units, including causes of infertility, hormonal treatments, procedures (e.g., IVF), and important covariates (e.g., parity, body mass index, etc.). To date we have collected exposure and covariate information from 18,470 women receiving treatment at 9 IVF clinics and conducted an interim linkage with the cancer registry through December 2014, providing on average 15 years of follow-up. We calculated standardized incidence ratios (SIRs) for all cancers combined and separately for breast cancer and further evaluated breast cancer risk with number of treatment cycles using Cox proportional hazards regression. Results: Based on interim registry linkage we identified 611 invasive cancers including 272 breast cancers among 18,470 women with more than 236,000 woman-years of follow-up. The incidence of cancer [SIR (95% confidence interval (CI)): 0.96 (0.88-1.04)] or breast cancer [0.98 (0.87-1.11)] was not elevated compared to the general population. Further, breast cancer risk was not associated with increased number of IVF treatment cycles [adjusted hazard rate ratio (RR) (95% CI) per IVF cycle: 1.01 (0.96-1.09)]. Conclusions: With this data we have demonstrated the feasibility of linking IVF clinic data with the nationwide cancer registry to evaluate cancer risk. In our preliminary analyses, IVF treatment was not associated with risk of incident invasive cancer or breast cancer. Given that continued linkage with the cancer registry is feasible, we will be able to monitor long-term cancer risks associated with IVF treatment using the enumerated data. This abstract is also being presented as Poster A15. Citation Format: Britton Trabert, Galit Hirsh-Yechezkel, Adel Farhi, Inna Zaslavsky, Shai E. Elizur, Arik Kahana, Raoul Orvieto, Hananel Holzer, Ilan Calderon, Shevach Friedler, Einat Shalom-Paz, Raphael Ron-El, Arie Raziel, Louise A. Brinton, Liat Lerner-Geva. Utilizing electronic fertility clinic records and registry linkage to establish a retrospective population-based cohort study to evaluate the association between in vitro fertilization (IVF) and subsequent cancer risk in women [abstract]. In: Proceedings of the AACR Special Conference on Modernizing Population Sciences in the Digital Age; 2019 Feb 19-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(9 Suppl):Abstract nr PR05.

The Norwegian Armed Forces Health Registry conscription board health examinations 1968-2018.

Aim: The aim of the study is to encourage further research initiatives and collaborations based on Norwegian Armed Forces Health Registry (NAFHR) data by presenting basic information on the data contained therein. Methods: We describe how conscription board health examinations (CBHEs) are carried out, how results are recorded in the NAFHR, and the completeness of NAFHR data that are electronically available for research purposes. Results: In December 2018, the NAFHR contained data on nearly 1.5 million Norwegian citizens (95% men) who attended CBHE in 1968-2018 at the age of 17-19 years. The percentage of persons included from each birth cohort has varied as the Armed Forces' personnel requirements and filing procedures have changed, increasing from 73% of eligible men born in 1950 to 95% of eligible men born in 1960-1991. In 2010 a preselection of candidates was implemented wherefore less than half of men born in 1992-2000 are registered in the NAFHR. Information on aerobic fitness, cognitive general ability, height and weight is registered for approximately 95% of individuals included in the NAFHR. The NAFHR contains more detailed health information for CBHEs that took place as from 1980, and information included from 2011 onwards is the most detailed. Unique, national personal identification numbers may be used to link the NAFHR to other health registries or data sources for public health research. Conclusions: The NAFHR contains CBHE data on the majority of Norwegian men and a substantial number of women born since 1950. NAFHR data represent a valuable resource for research collaborations.

Reporting results in U.S. clinical trials for obstructive sleep apnea and insomnia: How transparent are they?

BackgroundClinical trial transparency is important for scientific research and for the good of the general public. Diversity of study samples by race/ethnicity, gender, and age is important to ensure that results are generalizable. Moreover, reporting results might also be necessary to engage racial/ethnic minorities in clinical research. The primary objective of this study was to describe the results of clinical studies conducted for obstructive sleep apnea (OSA) and insomnia, two of the most prevalent sleep disorders. The secondary objective was to identify which factors were associated with voluntarily reporting the results. MethodsWe reviewed ClinicalTrials.gov, the public database of biomedical and behavioral research operated by the United States (U.S.) National Library of Medicine at the National Institutes of Health to ascertain the reports of demographic variables, including race/ethnicity of the studies conducted for OSA and insomnia. Since reporting race/ethnicity was an optional data feature, we searched for publications in PubMed using the unique national clinical trial identification number (NCTID). The national clinical trial identification number is assigned as soon as the trial is registered. The article extraction was conducted by graduate students and supervised by N.J.W. ResultsWe identified 427 studies on OSA and 404 studies on insomnia. Results were reported for 122 studies. Based on the 122 studies with results that included studies that were terminated (n = 16) and/or completed (n = 105), and one study was listed as “active” but not recruiting. 46.7% studies involved drugs, 30.3% studied a medical device, and 8.2% investigated behavioral interventions. The age range of subjects was 2–99 years of age and 16.4% included an age range of 35-50 years. Twenty-nine studies (23.8%) reported race/ethnicity in ClinicalTrials.gov. Of these, 74% of subjects were white (n = 2,953); 20% black (n = 822); 1% Asian American (n = 40); 2% Hispanic/Latino (n = 77); and 3% of study subjects identified race/ethnicity as “other” (n = 118). With the PubMed search, we found an additional 24 studies that reported race/ethnicity. There was no difference in reports of race/ethnicity between studies for insomnia and studies for OSA. The intervention type labeled as “behavioral” was a significant predictor (odds ratio: 12.49, P-value ≤ .05, confidence interval: 1.002-155.62) for reporting results. ConclusionThe National Institutes of Health has mandated federally funded research include women and minorities and that they are representative of the U.S. population. Though gender was reported, few investigators and study sponsors reported the results of race/ethnicity, which begs the question about trial transparency for the future of sleep research. Presumably, the lack of reporting is related to low enrollment of ethnic/minorities included in these studies. Nonetheless, our key finding warrants increased attention to minority participation in sleep clinical studies and trial transparency.

CHADS2 and CHA2DS2-VASc scores as tools for long-term mortality prognosis in patients with typical atrial flutter after catheter ablation.

The CHADS2and CHA2DS2-VASc scores were shown to predict mortality in patients with atrial fibrillation. However, pathophysiology and treatment outcomes of atrial fibrillation and typical atrial flutter (AFL) differ. Consequently, the prognosis of patients with AFL can also be different. The aim of the study was to assess CHADS2and CHA2DS2‑VASc scores as mortality predictors in patients with typical AFL. Large cohort of consecutive patients with typical AFL who underwent catheter ablation was retrospectively analyzed. The CHADS2and CHA2DS2‑VASc were calculated using hospital record data. All-cause mortality data was obtained from the registry of national personal identification numbers. The Kaplan-Meier method and multivariable Cox proportional hazard models were applied for survival and hazard ratio analyses, respectively. A total of 469 patients hospitalized for typical AFL ablation were enrolled (mean [SD] age, 63.7 [12.2] years; male sex, 69.1%). Patients were followed from 2 to 12 years resulting in 2974 patient‑years of follow‑up. The Kaplan-Meier survival analysis revealed a negative impact of each component of the CHADS2and CHA2DS2‑VASc scores on survival with the exception of stroke (not significant) and female sex (related to abetter survival). Consequently, higher scores were predictive of higher all‑cause mortality rates (2.7%-54% at 10 years); the CHA2DS2‑VASc score was equally predictive as the CHADS2score. In patients referred for typical AFL ablation, the CHADS2score can be applied for prognostic assessment. A successful AFL ablation procedure should not divert the attention from recognizing and addressing other medical issues that have an impact on long‑term mortality, which remains very high in this population of patients.

Unique health identifiers for universal health coverage

Identifying everyone residing in a country, especially the poor, is an indispensable part of pursuing universal health coverage (UHC). Having information on an individuals’ financial protection is also imperative for measuring the progress of UHC. This paper examines different ways of instituting a system of unique health identifiers that can lead toward achieving UHC, particularly in relation to utilizing universal civil registration and national unique identification number systems. Civil registration is a fundamental function of the government that establishes a legal identity for individuals and enables them to access essential public services. National unique identification numbers assigned at birth registration can further link their vital event information with data collected in different sectors, including in finance and health. Some countries use the national unique identification number as the unique health identifier, such as is done in South Korea and Thailand. In other countries, a unique health identifier is created in addition to the national unique identification number, but the two numbers are linked; Slovenia offers an example of this arrangement. The advantages and disadvantages of the system types are discussed in the paper. In either approach, linking the health system with the civil registration and national identity management systems contributed to advancing effective and efficient UHC programs in those countries.

A Framework for the Deployment of the National Identification Number for Patients with Health Related Issues

A Framework for the Deployment of the National Identification Number for Patients with Health Related Issues

A Framework for the Deployment of the National Identification Number for Patients with Health Related Issues

A Framework for the Deployment of the National Identification Number for Patients with Health Related Issues

Progress in Testing for and Treatment of Hepatitis C Virus Infection Among Persons Who Inject Drugs - Georgia, 2018.

In April 2015, the country of Georgia, with a high prevalence of hepatitis C virus (HCV) infection (5.4% of the adult population, approximately 150,000 persons), embarked on the world's first national elimination program (1,2). Nearly 40% of these infections are attributed to injection drug use, and an estimated 2% of the adult population currently inject drugs, among the highest prevalence of injection drug use in the world (3,4). Since 2006, needle and syringe programs (NSPs) have been offering HCV antibody testing to persons who inject drugs and, since 2015, referring clients with positive test results to the national treatment program. This report summarizes the results of these efforts. Following implementation of the elimination program, the number of HCV antibody tests conducted at NSPs increased from an average of 3,638 per year during 2006-2014 to an average of 21,551 during 2015-2018. In 2017, to enable tracking of clinical outcomes among persons who inject drugs, NSPs began encouraging clients to voluntarily provide their national identification number (NIN), which all citizens must use to access health care treatment services. During 2017-2018, a total of 2,780 NSP clients with positive test results for HCV antibody were identified in the treatment database by their NIN. Of 494 who completed treatment and were tested for HCV RNA ≥12 weeks after completing treatment, 482 (97.6%) were cured of HCV infection. Following the launch of the elimination program, Georgia has made much progress in hepatitis C screening among persons who inject drugs; recent data demonstrate high cure rates achieved in this population. Testing at NSPs is an effective strategy for identifying persons with HCV infection. Tracking clients referred from NSPs through treatment completion allows for monitoring the effectiveness of linkage to care and treatment outcomes in this population at high risk, a key to achieving hepatitis C elimination in Georgia. The program in Georgia might serve as a model for other countries.