National Information System Research Articles

Evaluation of the impact of health policies on the provision of health

The Government of Saudi Arabia has made expanding access to quality medical care a top priority in all three phases (primary, secondary, and tertiary) through health policies, starting with primary care. As a direct result of this, there has been a significant rise in the general level of health among Saudi citizens over the past few decades. However, several issues present challenges to the healthcare system. These include a shortage of Saudi health professionals, the multiple roles played by the Ministry of Health, limited financial resources, changing disease patterns, high demand due to free services, the absence of a national policy for crisis management, poor access to some health services, and the need for a national health information system and the condition to utilize the potential offered by e-health strategies. The study found that primary, secondary, and tertiary health care in the Kingdom of Saudi Arabia has progressed significantly in recent years thanks to the continuous focus and funding from the government. Thus, the health of the Saudi people has improved dramatically. The Ministry of Health (MOH) has implemented several service improvements, focusing on Primary Health Care (PHC).

Information Technology in the Implementation of Land Registration Activities: The Implementation Side

This study aims to determine how the implementation of land registration activities through information technology activities at the Regional Office of the National Land Agency of South Sulawesi Province in the Division of Determination and Registration of Rights and what factors affect land registration activities through the application of information technology at the Regional Office of the National Land Agency of South Sulawesi Province in the Division of Determination and Registration of Rights. The results of this study indicate that the implementation of land registration activities through the application of Information Technology in the Regional Office of the National Land Agency of South Sulawesi Province was implemented on Law of Information and Electronic Transactions. In addition, related to the implementation of technology utilization, of course, there are problems that are present, one of which is external factors in land registration, community factors are very influential on the smooth process of land registration activities. Without community support, community activities will not run effectively. And internal factors sociologically, every law enforcer has a position and role. The position is a container in which certain rights and obligations are contained. In order for this to work as desired, the author suggests that there needs to be more attention to communication aspects and aspects of service quality at the Regional Office of the National Land Agency of South Sulawesi Province in the Division of Determination and Registration of Rights. This is because there are still employees who do not understand the national land management information system policy well. And it is also necessary to improve the quality of service by paying attention to supporting factors in making services easier and faster. And the need for additional human resources or recruitment of new employees who are able to apply Information Technology, the need to improve the quality of a better internet network and improve/update existing hardware and application software and improve KKP applications managed by the central BPN, and the need for counseling/understanding of land registration activities to the community.

Implementing Technology Invention For Micro, Small, And Medium-Sized Enterprises’ Human Resource Improvement: A Conceptual Model

Micro, Small, and Medium-Sized Enterprises (MSMEs) in Indonesia are now commercial organizations that can employ many people. There is a need for an efficient information system since there is a dearth of knowledge about marketing goals, despite the fact that many different MSME products have the potential to become high-quality exports. The more people there are who utilize the internet, the more probable it is that businesses will benefit from the increased competition. Therefore, the information system must provide MSMEs with access to digital marketing databases. To address this challenge, this piece presents a theoretical framework for applying technological innovation to the enhancement of human resources in micro, small, and medium-sized enterprises (MSME). Given the current shortcomings of HR improvement procedures in Indonesian MSMEs, this paper offers a comprehensive evaluation as a template for development in the field. In this article, we compare the current HR improvement practice in Indonesian MSMEs to national and international practices reported in the literatures reviewed and conclude that, in accordance with the national marketing information system of MSME owners, implementing technology invention has the potential to support HR improvement in Indonesian MSMEs.

Management of emergency department diversion during the COVID-19 pandemic and disaster periods.

Recent news has shown the strain on hospital emergency departments (EDs) and emergency medical services agencies due to the surge of COVID-19; however, compared to all emergency medical service transports, is it true that the United States is seeing an increase in the frequency of diversions? In this quantitative research report, data were collected and analyzed from a national prehospital emergency medical services information system, which allowed for a comparison of the frequency of diverted ambulances, transport times, and final patient acuity of patients arriving by diverted ambulances before and during the COVID-19 pandemic. Statistical analysis was performed on data obtained from the National Emergency Medical Services Information System to compare the frequency of ambulance diversion prior to the COVID-19 disaster and during COVID-19. Analysis of data obtained from the National Emergency Medical Services Information System found that there was not a significant increase in the percentage of ambulance transports that were diverted during the COVID-19 pandemic compared to before the pandemic. However, there were significant increases in the volume of all transports and diverted transports during the COVID-19 pandemic (p < 0.01 for both measures). The significant increases seen in the demand for services, combined with an overall downward trend in the number of healthcare facilities, have resulted in an increase in the volume of diversions, despite the overall demand increasing as well. The COVID-19 pandemic serves as a disaster/public health crisis that is subject to the same phases compared to other types of disasters. The significant findings of this report should provide the emergency services field a big picture, understanding that the problem at hand is multifaceted, with these findings shining light on the effects of current issues between emergency services and hospital EDs.

Prevention of multiple whole blood donations by an individual at the same month through the creation of a national Deferred Donor Registry (DDR)

IntroductionThe Colombian National Institute of Health administers the National Information System of Haemovigilance (SIHEVI-INS). Today, SIHEVI-INS constitutes a national blood donor and recipient database, which contains a national deferred donor registry (DDR), allowing blood banks to take acceptance or rejection decisions of a potential donor in real time. The study aimed to determine the rate of people who have made more than one whole blood donation monthly in Colombia, violating the national guideline of intervals between donations (three months for men and four for women), since DDR implementation. MethodsWe detected the unique personal identification number of people who, in 30 calendar days, made more than one whole blood donation at any of the 83 blood banks set up in Colombia. There were three comparison periods: 01/01/2018–08/31/2019 (launch of SIHEVI-INS and first national feedback); 09/01/2019–12/31/2020 (second feedback) and 01/01/2021–09/30/2022 (massive incorporation of web services). ResultsFor the first period, blood banks accepted 18.0 donations per 1000 people. There was a rate of 28.8 people/10,000 donations who had donated whole blood twice within 30 days. In the second period, there were 17.0 donations/1000 people and a rate of 2.1 people/10,000 donations (OR:14.0 CI95 %:12.2–16.0). For the last period, there were 18.2 donations/1000 people and a rate of 0.9 individuals/10,000 donations (OR:31.3 CI95 %:26.6–36.9, p < 0.001). ConclusionDDR reduced by 31 times the acceptance of blood donors who made more than one whole blood donation in the same month. It was necessary to provide periodic feedback and promote web service implementation to reduce this risky behavior.

Cost-Effectiveness Analysis of Combined Chemotherapy Regimen Containing Bedaquiline in the Treatment of Multidrug-Resistant Tuberculosis in China*

ObjectiveThis study aims to estimate the cost-effectiveness of the combined chemotherapy regimen containing Bedaquiline (BR) and the conventional treatment regimen (CR, not containing Bedaquiline) for the treatment of adults with multidrug-resistant tuberculosis (MDR-TB) in China. MethodsA combination of a decision tree and a Markov model was developed to estimate the cost and effects of MDR patients in BR and CR within ten years. The model parameter data were synthesized from the literature, the national TB surveillance information system, and consultation with experts. The incremental cost-effectiveness ratio (ICER) of BR vs. CR was determined. ResultsBR (vs. CR) had a higher sputum culture conversion rate and cure rate and prevented many premature deaths (decreased by 12.8%), thereby obtaining more quality-adjusted life years (QALYs) (increased by 2.31 years). The per capita cost in BR was as high as 138,000 yuan, roughly double that of CR. The ICER for BR was 33,700 yuan/QALY, which was lower than China’s 1× per capita Gross Domestic Product (GDP) in 2020 (72,400 yuan). ConclusionBR is shown to be cost effective. When the unit price of Bedaquiline reaches or falls below 57.21 yuan per unit, BR is expected to be the dominant strategy in China over CR.

Spatial analysis of vaccine coverage in children under the age of 1 year by mesoregions in Paraíba a northeastern Brazilian state.

Immunization is one of the most effective measures in public health, and it is responsible for the reduction of vaccine-preventable diseases. In the present study, vaccine coverage (VC) and the spatial dynamics of homogeneity of VC (HVC) were compared and analyzed in the terms of the immunobiologicals administered to children aged < 1 year in a state in Paraíba, Brazil. This is a mixed ecological study that used public-domain secondary data from the years 2016 and 2017 from the Information System of the Brazilian National Immunization Program (SI-PNI) and the Brazilian National Information System of Live Births (SINASC). VC rates were calculated by dividing the number of administered doses by the number of live births. Then, VC was classified into four categories. The Municipal HVC was considered adequate when the overall VC exceeds 75%. The study included a descriptive analysis and a spatial autocorrelation analysis for HVC using global and local Moran's statistics. The stratified VC analysis revealed a significant number of municipalities in each of the state's mesoregions with low or very low VC rates for all immunobiologicals, with the Mata Paraibana mesoregion having the worst percentages in both years studied. The spatial analysis of HVC revealed several clusters of inadequate homogeneity, with Mata Paraibana being the worst mesoregion in 2016. The analysis of spatial dynamics and spatial statistics techniques allows the precise identification of vulnerable areas, "vaccination pockets," making it possible to develop plans aimed at meeting the targets of the PNI.

Technological, political and economic challenges of urban solid waste in the state of Pará, Brasil

Due to population growth and urbanization itself, the amount of urban solid waste generated every day that needs to be destined for an environmentally appropriate purpose is increasing, therefore, this article aimed to investigate and analyze the technological, political and economic challenges of urban solid waste in the State of Pará. In methodological terms, a bibliographic review was carried out based on scientific articles that deal with the theme of this work and document analysis on the management of solid waste, its problems and challenges in the state of Pará. The data used are primary and secondary, they were collected in November 2022 on the platform of the national information system on solid waste management (SINIR) and the National Sanitation Information System (SNIS). For the execution of the work, the information considered was about the generation, collection, disposal and treatment of urban solid waste in the state of Pará, in addition to compliance with the National Solid Waste Policy. After that, the data analysis step was done through graphs and tables to represent the information studied. The results showed that the only technology to which urban solid waste in the state was destined until the year 2019 was recycling, and that the main method of collecting this waste was selective collection. Most municipalities do not properly dispose of their waste or even do not provide data on this situation, which can generate management difficulties. In addition, several financial support mechanisms were found for the destination of this waste.

Digital Health Information Systems in the Member States of the Commonwealth of Independent States: Status and Prospects

This paper examines the status of the development of national digital health information systems (HIS) in Commonwealth of Independent States (CIS) member states. Data for research were collected using a questionnaire adapted from the questionnaire of the WHO’s Third Global Survey on eHealth. The results showed that the digital transformation of HIS was occurring in all seven CIS member states (participating in the study), which were financed by different resources. Laws and regulations on electronic medical records (EMR) use were present in almost all participating CIS member states. Various international standards and classifications were used to support development and the interoperability of digital health information system (d-HIS), including International Classification of Diseases (ICD), Digital Imaging and Communications in Medicine (DICOM), ISO 18308, Logical Observation Identifiers, Names, and Codes (LOINC), Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT), and ISO TC 215. Several CIS member states had adopted a national information security strategy for the safe processing of both personal data and medical confidential information. The digital transformation of healthcare and the Empowerment through Digital Health initiative are taking place in all CIS member states, which are at different stages of introducing electronic medical and health records.

Health care resource use and costs among patients with carcinoid syndrome in France: Analysis of the National Health Insurance Database

ObjectivesCarcinoid syndrome (CS) develops in approximately 20% of patients with neuroendocrine tumours (NET). This study described healthcare resource utilization and its associated costs among patients with NET and CS, using the French national health care data system. MethodsPatients were included if they had a hospital stay associated with the code E34.0 "CS" and at least one delivery of a somatostatin analogue (SSA) between 01/01/2012 and 31/12/2016. The end of the analysis was either 31/12/2017 or the date of death, whichever occurred first. Mean overall costs were described by item of expenditure and by periods. Results646 patients were included: 64yo, 55% men, 64% and 15% had NET from the small-intestine or lung, respectively. Among them, 309 patients were incident and 271 died during the study period. Mean overall cost per person per month (PPPM) was €2,892: €3,273 for the first year following diagnosis, €2,574 in “middle-years” and €5,039 within the year preceding death. The two most costly expenditure items were drugs (€1,695 PPPM) and hospital stays (€870 PPPM). ConclusionThe first year following diagnosis and the year preceding death are the two periods representing the highest costs for CS care in France. Successful disease management may contribute to lower costs in the intermediate period.

INFORMACIONI SISTEM O ISTRAŽIVAČKOJ DJELATNOSTI U BOSNI I HERCEGOVINI: E-CRIS.BH I PERSONALNE BIBLIOGRAFIJE ISTRAŽIVAČA / CURRENT RESEARCH INFORMATION SYSTEM IN BOSNIA AND HERZEGOVINA: E-CRIS.BH AND PERSONAL BIBLIOGRAPHIES

The aim of this paper is to present the Information System on Research Activity in Bosnia and Herzegovina - E-CRIS.BH, and the total number of registered researchers, research organizations, departments and projects, but also the number of bibliographic records to which the typology of documents/works has been assigned within the mutual COBISS.BH database. E-CRIS.BH is an information system that represents an electronic database of researchers, research organizations, research departments and research projects. It is an information system on research activities in Bosnia and Herzegovina, which originated from the Register of Scientific Institutions, Scientific Staff, Scientific and Research Projects and Infrastructure Investments in the Federation of Bosnia and Herzegovina and the Register of Scientific Institutions, Scientific Staff, Scientific and Research Projects and Infrastructure Investments in Canton of Sarajevo. The Register of the Federation of Bosnia and Herzegovina is conceived as an umbrella system and the registers of the canton as its subsystems. The project was implemented by the Academy of Sciences and Arts of Bosnia and Herzegovina. The connection of E-CRIS.BH with the bibliographic database of COBISS.BH provides insight into the bibliographies of researchers, which are an integral part of every scientific work, a condition for synthesizing knowledge and data that lead to the required scientific results. The COBISS users have the opportunity to record researchers, research organizations, departments and projects necessary for the creation of a bibliography of researchers and organizations within their national library information systems in the COBISS.Net network (regional network). The results show that 2.230 researchers and 86 organizations have been registered so far in E-CRIS.BH. A total of 73.657 bibliographic records have been created so far within the COBISS.BH common database, which a typology of documents/works has been assigned to. In the first group – articles and other components – a typology was determined for 21.122 bibliographic records. In the second group – monographs and other completed works - a typology was determined for 52.372 bibliographic records. In the third group – performed works - (events) – a typology was determined for 163 bibliographic records.

Survey and analysis of computer emergency response team services

This article discusses the functions and services of CERTs. First CERT was created with the goal to have more organized and structured approach to the computer security incident handling process. The creation of such CERTs contributes to an increase in the country’s global cybersecurity index. Services that KZ-CERT provide to protect people using the Internet from malicious activity of intruders are analyzed. KZ-CERT is the center for users of national information systems and the Internet segment, which provides the collection and analysis of information on computer incidents, advisory and technical support to users in preventing computer security threats. The competence of the service includes the processing of the computer incidents in order to identify and neutralize them.

Paediatric hospitalizations over three waves of COVID-19 (February 2020 to May 2021) in Italy: determinants and rates.

After a pneumonia outbreak in late 2019 in China, a new virus related to the Coronaviridae strain, called Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), was identified as the pathogen of an emerging disease known as COronaVIrus Disease 19 (COVID-19). Preliminary evidence outlines a higher prevalence in adults and lower susceptibility in children. However, recent epidemiologic research highlighted that transmissibility and susceptibility among children and adolescents become higher due to new virus variants. Infections among youth arises with mainly respiratory and gastrointestinal symptoms and malaise. Nevertheless, critical illness affects new-borns and fragile children, requiring hospitalization and possibly intensive care support. Aim of this study was to examine the impact of COVID-19 pandemic on hospital admissions among children and adolescents aged 0 to 17 years over three waves of COVID-19 (from February 2020 to May 2021) in Piedmont, a large Italian region, and to investigate the possible determinants of hospitalizations. A meta-analysis for risk assessment was performed over three waves of COVID-19 (from February 2020 to May 2021). Data were extracted from the official Italian National Information System and ISTAT. Overall, 442 paediatric patients were enrolled and admissions concerned mostly the age group 0-4 years (60.2%). Trends of hospitalization showed a slight increase of paediatric admissions already in March 2020 and a rise during second and third waves (November 2020, March 2021). Paediatric age-grouped hospitalizations (0-4; 12-17; 5-11) reproduced an analogous trend. The children and adolescent hospitalization rate appeared lower than overall population with a moderate slope of increase in comparison with population slope. Monthly hospitalization rate (per 100,000) of children and adolescents aged 0-17 years reproduced the increasing trend of hospitalization numbers. This trend was influenced, in particular, by the trend of hospitalization rates for children aged 0-4 years. The meta-analysis for risk assessment showed a decreased likelihood of rescue of hospitalizations in female, 5-11 and 12-17 age groups. Conversely, the meta-analysis showed a positive association between foreign nationality and hospitalizations. Our results show a comparable trend of paediatric hospital admissions for COVID-19 and of the entire population hospitalizations over three waves. COVID-19 hospital admissions increase with a bimodal age distribution and the most admissions are among patients aged ≤4 or 5-11 years. Significant predictive factors of hospitalization are identified.

An assessment of the Ethiopian national rural land administration information system conceptual model using LADM as a reference

The Land Administration and Use Directorate of the Ministry of Agriculture in Ethiopia designed a National Rural Land Administration Information System (NRLAIS). Its purpose was to align with the development of international standards in the land administration domain, specifically the Land Administration Domain Model (LADM), and to ensure the security of cadastral data. The findings revealed the necessity of designing the conceptual model and comparing NRLAIS classes with the LADM basic classes accepted by the International Organization for Standardization (ISO 19152). Though the comparison showed compatibility between the two, some differences are observed in classes and attributes between the LADM and the NRLAIS. Gaps were identified on recording types of rights, restrictions, responsibilities and land legislation gaps. This study highlights the importance of adopting the LADM to restructure the NRLAIS conceptual model and reconsider the missing components to enhance the conceptual model and management of rights, restrictions, and responsibilities.

Socio-demographic and cultural factors related to non-participation in the Dutch colorectal cancer screening programme

BackgroundHigh participation rates are essential for a screening programme to be beneficial. To reach non-participants in a targeted manner, insight in characteristics of non-participants is needed. We investigated demographic differences between participants and non-participants in the Dutch faecal immunochemical test-based colorectal cancer (CRC) screening programme. MethodsIn this population-based cohort study, we included all invitees for CRC screening in 2018 and 2019. Participation status, birth year, and sex were extracted from the Dutch national screening information system and linked to demographic characteristics from Statistics Netherlands, including migration background, level of education, socioeconomic category, household composition, and household income. A multivariable logistic regression was used to assess the association between demographic factors and participation. ResultsA total of 4,383,861 individuals were invited for CRC screening in 2018 and 2019, of which 3,170,349 (72.3%) participated. Individuals were less likely to participate when they were single and/or living with others (single with other residents versus couple: odds ratio [OR] 0.34, 95% confidence interval [CI]: 0.31–0.38), had a migration background (e.g. Moroccan migrant versus Dutch background: OR 0.43, 95% CI: 0.42–0.44), or had a low income (lowest versus highest quintile: OR 0.45, 95% CI: 0.44–0.45). Although to a lesser extent, non-participation was also significantly associated with being male, being younger, receiving social welfare benefits and having a low level of education. ConclusionWe found that individuals who were single and/or living with others, immigrants from Morocco or individuals with low income were the least likely to participate in the Dutch CRC screening programme. Targeted interventions are needed to minimise inequities in CRC screening.

Impact of social and demographic factors on the spread of the SARS-CoV-2 epidemic in the town of Nice

IntroductionSocio-demographic factors are known to influence epidemic dynamics. The town of Nice, France, displays major socio-economic inequalities, according to the National Institute of Statistics and Economic Studies (INSEE), 10% of the population is considered to live below the poverty threshold, i.e. 60% of the median standard of living.ObjectiveTo identify socio-economic factors related to the incidence of SARS-CoV-2 in Nice, France.MethodsThe study included residents of Nice with a first positive SARS-CoV-2 test (January 4-February 14, 2021). Laboratory data were provided by the National information system for Coronavirus Disease (COVID-19) screening (SIDEP) and socio-economic data were obtained from INSEE. Each case’s address was allocated to a census block to which we assigned a social deprivation index (French Deprivation index, FDep) divided into 5 categories. For each category, we computed the incidence rate per age and per week and its mean weekly variation. A standardized incidence ratio (SIR) was calculated to investigate a potential excess of cases in the most deprived population category (FDep5), compared to the other categories. Pearson’s correlation coefficient was computed and a Generalized Linear Model (GLM) applied to analyse the number of cases and socio-economic variables per census blocks.ResultsWe included 10,078 cases. The highest incidence rate was observed in the most socially deprived category (4001/100,000 inhabitants vs 2782/100,000 inhabitants for the other categories of FDep). The number of observed cases in the most social deprivated category (FDep5: N = 2019) was significantly higher than in the others (N = 1384); SIR = 1.46 [95% CI:1.40–1.52; p < 0.001]. Socio-economic variables related to poor housing, harsh working conditions and low income were correlated with the new cases of SARS-CoV-2.ConclusionSocial deprivation was correlated with a higher incidence of SARS-CoV-2 during the 2021 epidemic in Nice. Local surveillance of epidemics provides complementary data to national and regional surveillance. Mapping socio-economic vulnerability indicators at the census block level and correlating these with incidence could prove highly useful to guide political decisions in public health.

Area-specific covid-19 effects on health services utilization in the Democratic Republic of the Congo using routine health information system data

BackgroundSince March 2020, the COVID-19 pandemic has shocked health systems worldwide. This analysis investigated the effects of the pandemic on basic health services utilization in the Democratic Republic of the Congo (DRC) and examined the variability of COVID effects in the capital city Kinshasa, in other urban areas, and in rural areas.MethodsWe estimated time trends models using national health information system data to replicate pre-COVID-19 (i.e., January 2017–February 2020) trajectories of health service utilization, and then used those models to estimate what the levels would have been in the absence of COVID-19 during the pandemic period, starting in March 2020 through March 2021. We classified the difference between the observed and predicted levels as the effect of COVID-19 on health services. We estimated 95% confidence intervals and p-values to examine if the effect of the pandemic, nationally and within specific geographies, was statistically significant.ResultsOur results indicate that COVID-19 negatively impacted health services and subsequent recovery varied by service type and by geographical area. COVID-19 had a lasting impact on overall service utilization as well as on malaria and pneumonia-related visits among young children in the DRC. We also found that the effects of COVID-19 were even more immediate and stronger in the capital city of Kinshasa compared with the national effect. Both nationally and in Kinshasa, most affected services had slow and incomplete recovery to expected levels. Therefore, our analysis indicates that COVID-19 continued to affect health services in the DRC throughout the first year of the pandemic.ConclusionsThe methodology used in this article allows for examining the variability in magnitude, timing, and duration of the COVID effects within geographical areas of the DRC and nationally. This analytical procedure based on national health information system data could be applied to surveil health service disruptions and better inform rapid responses from health service managers and policymakers.

Pneumococcal vaccination coverage at the initiation of chronic dialysis, and its association with mortality during the first year.

Pneumococcal immunization is recommended in dialysis patients. We aimed to estimate pneumococcal vaccination coverage among patients who initiate dialysis in France, and its association with mortality. Data were extracted from two prospective national databases, merged using a deterministic linkage method: renal epidemiology and information network (REIN) registry, which includes all patients on dialysis and kidney transplants recipients in France, and the national health insurance information system (SNIIRAM) which collects individual data on health expenditure reimbursement, including vaccines. We enrolled all patients who initiated chronic dialysis in 2015. Data on health status at dialysis initiation, dialysis modalities, and pneumococcal vaccine prescribed from 2years before to 1year after dialysis start were collected. Univariate and multivariate Cox proportional hazard models were used to assess one-year all-cause mortality. Among the 8,294 incident patients included, 1,849 (22.3%) received at least one pneumococcal vaccine before (n=542, 6.5%), or after (n=1,307, 15.8%) dialysis start, as follows: 13-valent pneumococcal conjugated vaccine (PCV13) followed by 23-valent pneumococcal polysaccharide vaccine (PPSV23), n=938 (50.7%); only PPSV23, n=650 (35.1%); or only PCV13, n=261 (14.1%). Vaccinated patients were younger (mean, 66.5±14.8years vs. 69.0±14.9years, P≤0.001), more likely to suffer from glomerulonephritis (17.0% vs. 11.0%, P≤0.001), and less likely to start dialysis in emergency (27.2% vs. 31.1%, P=0.001). On multivariate analysis, patients who received PCV13 and PPSV23, or only PCV13 were less likely to die (respectively, HR=0.37; 95%CI 0.28-0.51, and HR=0.35; 95%CI 0.19-0.65). Pneumococcal immunization with PCV13 followed by PPSV23, or with PCV13 alone, but not with PPSV23 alone, is independently associated with decreased one year-mortality in patients who start dialysis.

Assessing European national health information systems in peer review format: lessons learnt.

Systematic assessments of a country's health information system (HIS) help identify strengths and weaknesses and may stimulate actions for improvement. They represent a capacity-building process for the country assessed as well as for the assessor. The joint action on HISs (InfAct) developed a peer-to-peer assessment methodology adapting an established WHO support tool. The aim of this study is to identify lessons learnt and the added value of the InfAct peer assessment for the assessors. A qualitative evaluation of the peer HIS assessment was performed based on 12 semi-structured interviews: nine interviews were carried out with assessors from nine participating countries, and three with an observer (present during assessments). The interviews were carried out between May 2019 and January 2020. Interviews were analysed using qualitative content analysis. The interviews revealed the experiences of the assessors mainly occurred in five areas: assessors strengthened their understanding of what a population-based HIS is; they strengthened their understanding of how a HIS operates in different countries; they learnt how to carry out a HIS assessment; they strengthened their organization, communication, negotiation and reporting skills and they strengthened the networks in health information within and between countries. Since the assessors are key personnel in their respective national health systems, the impact of the assessment is not limited to the assessor alone but may extend to stakeholders in their country. The deployment of the InfAct HIS peer assessment, anchored in systematic HIS capacity building across European countries, is recommended.

РАЗВИТИЕ ЗЕМЕЛЬНЫХ ОТНОШЕНИЙ В РФ С УЧЕТОМ ТРАНСФОРМАЦИИ КАТЕГОРИРОВАНИЯ, ОЦЕНКИ И КАДАСТРА ЗЕМЕЛЬ

In the context of the strategic priorities of the state program on the national spatial data system in the Russian Federation, the issue of comprehensive study of land resources from the point of view of improving their condition and correct management decision-making is being updated. The purpose of the work is to substantiate the study of theoretical and practical aspects of land relations, to identify problems arising in the process of assigning a category to lands, their cadastral valuation and cadastral works. The article uses general scientific methods; graphical interpretation of the data to ensure the reliability of the results of the study. Proposals are given on systematization, collection, processing and consolidation of data; provision of services in the field of state cadastral registration of immovable property and state registration of rights to it; improvement of the process of determining cadastral value in order to increase the efficiency of taxation and development of territories.