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606 FDCREP-A Database Designed for Antenatal Diagnostic Services
spa
Yoillme 166 l'\lIrnher 1, Part 2
606
607
FDCREP- A DATABASE DESIGNED FOR ANTENATAL DIAGNOSTIC SERVICES, D. Lagrew, H. Doanx, R. Steiger, Dept Ob/Gyn, Saddleback Memorial Medical Center, Laguna Hills, CA., and Univ. of California, Irvine, Orange, CA. Antenatal diagnostic centers follow patients with a range of prenatal diagnostic services which including u~rasound, genetic sampling and fetal well being studies. A comprehensive database was developed to collect data, generate reports and analyze resu~ of diagnostic services. The application was developed in RBASE, a PC-based database language. FDCREP is operating efficiently on a network system with 9 work stations. Data entry has been expedited by numeric coding. Redundant entries are minimized so that the system is time efficient. After entering data on 2932 patients, 4155 u~rasounds, 972 amniocenteses and 3479 antepartum tests, the database occupies 6.4 Meg of disk space. Data entry forms for u~rasound, patient demographics, past medical history, amniocentesis, and fetal testing have been developed. U~rasound calculations are made at the time of entry, Reports are generated for u~rasounds (gynecologic, 1st trimester, obstetrical), fetal well being (CST,NST,BPP,AFV), and amniocentesis (letter, tabular). In addition chronologic summary reports of fetal well being resu~s can be produced. Summary reports on numbers of tests, types of tests and referral usage are generated. The system allows for quality In summary a assurance analysis and research statistics. comprehensive database for antenatal services has been developed which requires a minimal amount of memory for archiving.
608
LDLOG - A DATABASE DESIGNED FOR SUMMARIZING AND MAINTAINING LABOR AND DELIVERY STATISTICS. D. Lagrew, H. Doanx, R. Steiger, Dept Ob/Gyn, Saddleback Memorial Medical Center, Laguna Hills, CA, and Univ. of California, Irvine, Orange, CA. Rapid and accurate statistics of labor and delivery information are required for hospital, local and state agencies. Such analysis allows for utilization analysis and quality improvement. In order to expedite entry and analysis a computerized labor and delivery database was developed. Written in RBASE, a PC-Based database program, the forms were developed with maternal and neonatal information. Numeric coding has allowed efficient storage with nearly 6000 deliveries being stored in 3.7 Meg of hard disk space. The efficient use of memory utilized by this program allows for the archiving of many years of data on one hard disk. A monthly summary including labor and delivery statistics, log of deliveries, and physician statistics are generated by the application. A breakdown of cesarean rates, indications and VBAC attempts are generated. Individual cesarean section reports analyze each physician's rate and risk factors. Summary logs by physician can be generated. The resu~s are utilized for quality improvement and utilization review. The timely feedback has allowed physicians to evaluate their own practice patterns.
609
Abstracts
A MULTI_USER PC AND MACINTOSH PERINATAL ULTRASOUND DATABASE FOR CLllITCAL AND RESEARCH USE.
B£.at..t..ifLRB., McLaughlin pX, Dept. Obstetrics! Gynaecology, Queens University Belfast, Northern
Ireland. A customised ultrasound database based on commercially available software (Omnis 5- Blythe Software) has been developed to meet the service and research needs of a regional referral unit with file sharing on a mixed PC and Apple Macintosh network. The user-interface is predominantly icon driven and affords easy and rapid entry of data with minimal typing and "point and click" selection of most options. The hierarchical relational database design permits unlimited entry of multiple pregnancies and ultrasound examinations with easy searching using standard and user-defined searches to identify mothers, fetuses or ultrasound examinations which meet the search criteria. Biometric and menstrual data are used to calculate gestational age and estimated fetal weight based on published formulae and to generate customised pregnancy specific growth curves based on an individual mother's demographic data and past obs~etric history. Data export to statistical and graphical programmes is easily accomplished whilst textual reports including management reccomendations are generated for clinical use and output to file, screen or printer as required. Doppler studies and ultrasound guided procedures such as CVS, Amniocentesis and Cordocentesis are catered for and a simple Perinatal Outcome module is included to allow the system to be used as a stand alone Perinatal database.
PRETERM BIRTH PREVENTION IN A lARGE MEDICAID POPULATION, R,C. Floyd,X R.W. Martin, K,S, Gookin,x W,E, Roberts, B,N, Mclaughlin,X J.C. Morrison, Dept, Ob/Gyn, Univ. Mi ssi ssippi Med, Ctr _, Jackson, MS Objective: Determine the results of a comprehensive program of premature birth prevention in Medicaid women. po~ulation: Over a 70-month period, 4008 pregnant Me 1ca1d patients (Group I) from 47 states received patient education, frequent cervical examinations, dal1y nurse contact and home uterine monitoring (Tokos Medical Corp" Santa Ana, CA), These were compared to a matched group (II) of women from one state (MS) who received high-risk standard care (N o 91), Those delivered for medical indications or because of patient/physician non-compliance were not included (N=996, 20 respectively), Main Outcomes Measured: In this retrospective study, the gestatlonal age at d1agnosis of preterm labor (PTl) and delivery, interval between tocolysis and birth in those with PTl, incidence of PTl, and number delivering deli vering preterm were recorded, Resul ts: In the 4008 patients there were 8702 risk facto~O (26".') were for PTl during the current pregnancy, Preterm delivery or PTl in a prior pregnancy and multi fetal gestations accounted for 43".', Multiple risk factors compri se the other 31'.' of moni to red subj ects, The ri sk factor percentage was siml1ar in Group II, GA at GA at Group Number PTl Diagnosis PTD Delivery I 3012 65".' 30,0 21".' 265 + 14 d II 71 61".' 29,3 46".' 238 12 d The percentage of women W1 th PTL 1n each group was siml1ar as was the gestational age at diagnosis of PTl. The gestational age at delivery (P < .001) was lower and the nuroer delivering < 37 weeks (P < .001) was higher in the group receiving standard care, Conclusions: In a large Medicaid population, a comprehensive program of intensive peri natal nurse assessment, aroul atory uteri ne monitoring, and aggressive provider care rendered better results concerning preterm delivery percentage than did a program of high-ri sk care alone,
+
435
Yoillme 166 l'\lIrnher 1, Part 2
606
607
FDCREP- A DATABASE DESIGNED FOR ANTENATAL DIAGNOSTIC SERVICES, D. Lagrew, H. Doanx, R. Steiger, Dept Ob/Gyn, Saddleback Memorial Medical Center, Laguna Hills, CA., and Univ. of California, Irvine, Orange, CA. Antenatal diagnostic centers follow patients with a range of prenatal diagnostic services which including u~rasound, genetic sampling and fetal well being studies. A comprehensive database was developed to collect data, generate reports and analyze resu~ of diagnostic services. The application was developed in RBASE, a PC-based database language. FDCREP is operating efficiently on a network system with 9 work stations. Data entry has been expedited by numeric coding. Redundant entries are minimized so that the system is time efficient. After entering data on 2932 patients, 4155 u~rasounds, 972 amniocenteses and 3479 antepartum tests, the database occupies 6.4 Meg of disk space. Data entry forms for u~rasound, patient demographics, past medical history, amniocentesis, and fetal testing have been developed. U~rasound calculations are made at the time of entry, Reports are generated for u~rasounds (gynecologic, 1st trimester, obstetrical), fetal well being (CST,NST,BPP,AFV), and amniocentesis (letter, tabular). In addition chronologic summary reports of fetal well being resu~s can be produced. Summary reports on numbers of tests, types of tests and referral usage are generated. The system allows for quality In summary a assurance analysis and research statistics. comprehensive database for antenatal services has been developed which requires a minimal amount of memory for archiving.
608
LDLOG - A DATABASE DESIGNED FOR SUMMARIZING AND MAINTAINING LABOR AND DELIVERY STATISTICS. D. Lagrew, H. Doanx, R. Steiger, Dept Ob/Gyn, Saddleback Memorial Medical Center, Laguna Hills, CA, and Univ. of California, Irvine, Orange, CA. Rapid and accurate statistics of labor and delivery information are required for hospital, local and state agencies. Such analysis allows for utilization analysis and quality improvement. In order to expedite entry and analysis a computerized labor and delivery database was developed. Written in RBASE, a PC-Based database program, the forms were developed with maternal and neonatal information. Numeric coding has allowed efficient storage with nearly 6000 deliveries being stored in 3.7 Meg of hard disk space. The efficient use of memory utilized by this program allows for the archiving of many years of data on one hard disk. A monthly summary including labor and delivery statistics, log of deliveries, and physician statistics are generated by the application. A breakdown of cesarean rates, indications and VBAC attempts are generated. Individual cesarean section reports analyze each physician's rate and risk factors. Summary logs by physician can be generated. The resu~s are utilized for quality improvement and utilization review. The timely feedback has allowed physicians to evaluate their own practice patterns.
609
Abstracts
A MULTI_USER PC AND MACINTOSH PERINATAL ULTRASOUND DATABASE FOR CLllITCAL AND RESEARCH USE.
B£.at..t..ifLRB., McLaughlin pX, Dept. Obstetrics! Gynaecology, Queens University Belfast, Northern
Ireland. A customised ultrasound database based on commercially available software (Omnis 5- Blythe Software) has been developed to meet the service and research needs of a regional referral unit with file sharing on a mixed PC and Apple Macintosh network. The user-interface is predominantly icon driven and affords easy and rapid entry of data with minimal typing and "point and click" selection of most options. The hierarchical relational database design permits unlimited entry of multiple pregnancies and ultrasound examinations with easy searching using standard and user-defined searches to identify mothers, fetuses or ultrasound examinations which meet the search criteria. Biometric and menstrual data are used to calculate gestational age and estimated fetal weight based on published formulae and to generate customised pregnancy specific growth curves based on an individual mother's demographic data and past obs~etric history. Data export to statistical and graphical programmes is easily accomplished whilst textual reports including management reccomendations are generated for clinical use and output to file, screen or printer as required. Doppler studies and ultrasound guided procedures such as CVS, Amniocentesis and Cordocentesis are catered for and a simple Perinatal Outcome module is included to allow the system to be used as a stand alone Perinatal database.
PRETERM BIRTH PREVENTION IN A lARGE MEDICAID POPULATION, R,C. Floyd,X R.W. Martin, K,S, Gookin,x W,E, Roberts, B,N, Mclaughlin,X J.C. Morrison, Dept, Ob/Gyn, Univ. Mi ssi ssippi Med, Ctr _, Jackson, MS Objective: Determine the results of a comprehensive program of premature birth prevention in Medicaid women. po~ulation: Over a 70-month period, 4008 pregnant Me 1ca1d patients (Group I) from 47 states received patient education, frequent cervical examinations, dal1y nurse contact and home uterine monitoring (Tokos Medical Corp" Santa Ana, CA), These were compared to a matched group (II) of women from one state (MS) who received high-risk standard care (N o 91), Those delivered for medical indications or because of patient/physician non-compliance were not included (N=996, 20 respectively), Main Outcomes Measured: In this retrospective study, the gestatlonal age at d1agnosis of preterm labor (PTl) and delivery, interval between tocolysis and birth in those with PTl, incidence of PTl, and number delivering deli vering preterm were recorded, Resul ts: In the 4008 patients there were 8702 risk facto~O (26".') were for PTl during the current pregnancy, Preterm delivery or PTl in a prior pregnancy and multi fetal gestations accounted for 43".', Multiple risk factors compri se the other 31'.' of moni to red subj ects, The ri sk factor percentage was siml1ar in Group II, GA at GA at Group Number PTl Diagnosis PTD Delivery I 3012 65".' 30,0 21".' 265 + 14 d II 71 61".' 29,3 46".' 238 12 d The percentage of women W1 th PTL 1n each group was siml1ar as was the gestational age at diagnosis of PTl. The gestational age at delivery (P < .001) was lower and the nuroer delivering < 37 weeks (P < .001) was higher in the group receiving standard care, Conclusions: In a large Medicaid population, a comprehensive program of intensive peri natal nurse assessment, aroul atory uteri ne monitoring, and aggressive provider care rendered better results concerning preterm delivery percentage than did a program of high-ri sk care alone,
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435