On Value And Its Key Influencing Factors Of Big Data-based Chronic Disease Management

?Objective?Chronic diseases have become a major public health problem in China,and the process of chronic disease management is essentially the process of creating value(health improvement,chronic disease control).This study constructs a model of chronic disease management based on the connotation and value connotation of chronic disease management through literature research.By the same time,through questionnaires and related statistical analysis,the key influencing factors of the management value of chronic diseases based on big data are determined.Finally,in the context of medical big data,based on the information ecological chain and dissipation structure,the formation mechanism and implementation strategy of chronic disease management based on big data are discussed.?Methods?1)Literature research.The value connotation and formation mechanism of chronic disease management are summarized,and the value index of chronic disease management based on big data is explored through the literature research.2)On-site investigation.Due to the high level of informationization in Qianjiang,Hubei,relevant personnel of chronic disease management in Health Commission,Central Hospital,township health clinics and village clinics in Qianjiang were selected to conduct a questionnaire survey to determine the relevant indicators of chronic disease management value.Through statistical screening and analysis,expert questionnaires for the key influencing factors of the management value of chronic diseases based on big data was finally formed.Relevant chronic disease management experts in Health Commission,township health clinics in Qianjiang were engaged to conduct a questionnaire survey to determine the key influencing factors.3)Mathematical statistics methods.Using Excel,SPSS19.0 and other statistical analysis software,the data of the sample were recorded and sorted,and the factor analysis was employed to eliminate and select the indicators,and the Fuzzy-DEMATEL statistical method was employed to determine the key factors.?Results?1)Based on the connotation and value connotation of chronic disease management,this study established a three-dimensional chronic disease management value model with “value subject,value orientation,value appeal and goal”.The value subject is the three subsystems of management,supply and demand involved in chronic disease management;the value orientation mainly includes demand side analysis,value proposition and value content;the value target includes basic value(security and accessibility,etc.)and common value(effectiveness and efficiency,etc.)and expanded value(patient-centered and equalized,etc.).2)A questionnaire survey on key factors of chronic disease management based on big data was conducted for those involved in chronic disease management.327 questionnaires were collected and 325 questionnaires were valid.Factor analysis is used to eliminate the influencing factors,and finally form a questionnaire based on big data for the management of key factors in the management of chronic diseases.It mainly includes three aspects: management level,technical level and behavior level.Through the questionnaire of expert questionnaire and fuzzy-dematel analysis,the ranking of importance(centrality)of each factor is obtained: policy and system(8.9758),manpower(8.6619),information quality(8.6520),infrastructure(8.5956),information circulation(8.5840),organization(8.5627),funding(8.4296),utilization skills of information technology(8.3561),information security(8.1822),health literacy(7.6449),severity of illness(6.6148).Among them,policies and systems,organization,infrastructure,funds,and severity of illness are the factors of chronic disease management value,which can have a greater impact on other factors;manpower,information quality,information circulation,utilization skills of information technology,information security,health literacy is the result of the value of chronic disease management and is greatly affected by other factors.3)The formation of chronic disease management value based on the ecological chain dissipation structure is divided into two parts.External mechanism includes policy and institutional guarantee,organizational guarantee,financial guarantee,human resources guarantee,infrastructure construction,and information security;internal mechanisms include information quality,information flow,and utilization skills of information technology.The internal mechanism is generally composed of three phases: the generation of information resources,the transmission of information resources(value formation),the processing and service of information resources(value creation).The generation of value resources includes the creation of value(from scratch),the increment(from less to more),the quality(from weak to excellent);the transfer of value resources includes the circulation of value(from break to pass),and aggregation(from division and integration;processing and service of value resources refers to the integration of value(from data to knowledge).?Conclusion?The value model of chronic disease management based on big data mainly includes three aspects: value subject,value orientation,value appeal and goal.The factors affecting the value subject's goal include policy and system and other factors such as information quality and information circulation.Based on internal and external factors,the mechanism of chronic management value formation is divided into two aspects,internal mechanism and external mechanism.In terms of external environment,the government and administrative departments need to strengthen the formulation of relevant policies and systems,including the rights and responsibilities of various value subjects and the clarification of sharing standards;and clarify the infringement abuse and privacy violations of electronic medical records,electronic health records,and related chronic disease data on medical APPs;standardize and supervise the determination and information quality of information system construction industry standards.In internal construction,it is necessary to strengthen organizational leadership and capital investment,further implement the informationization training and related ability assessment and performance incentives for medical staff,ensure the authenticity of data entry and update,and enhance the possibility of data circulation;strengthen the unification of data standards between different medical institutions,ensures the timeliness and continuity of data;strengthens the interconnection of electronic medical records within hospitals,strengthens the delivery of electronic medical records,health records,and personal health information,and strengthens the connection between personal health data and health administrative departments.