RESPIRATORY CARE TECHNOLOGY

Respiratory Care Technology

Respiratory Care Technology

Introduction

Since centuries, much has occurred in the direction of developments in computer technology and statistics and the availability of geographically referenced respiratory care information, making respiratory disease geography a growing subject of study. The most significant development may well be the origin of the field of geographic information science (GI Science) and the accompanying software programs that fall under the classification of geographic information systems (GIS). GIS is computer-based systems for integrating and analyzing spatially referenced data. These developments both increased the sophistication of the underlying philosophy guiding the study of respiratory disease geography and made it possible for researchers to manage complex analyses without requiring large amounts of computation time. GIS is organized to enable the integration of different types of geographical information (such as data associated with points, lines, polygons and field presentations) and to make readily available a number of cartographic and statistical operations that can be performed on these data. In tandem with developments GIS were developments in statistics-specifically spatial statistics-that make possible statistical modeling of risk, detection of clusters, hypothesis testing, simulation, and association studies.

The application of GIS and spatial statistics to health questions would not be possible without sufficient geo-referencing of respiratory care information. In recent years, it has become more commonplace for respiratory disease registries and public health authorities to allocate geographic codes or geo-codes-to respiratory care information, thus enabling the understanding of course in epidemiological and other analyses. Geo-codes can include latitude-longitude of residence, ZIP code, or census tract data, and the present geo-code often has significant implications on the type of analyses that can be performed. Along with developments in geo-coding, there has been increased interest with the confidentiality implications of the availability of finely geo-coded respiratory care information. Because of the ability to override geo-code health records (i.e., specify the address of a residence associated with a particular latitude-longitude coordinate attached to a respiratory disease record), data holders must be vigilant in releasing geo-coded data (Alberg, 2003).

A substantial command affecting the use of geo-coded respiratory control information is the Health Insurance Portability and Accountability Act (HIPAA) of 1996. This act, implemented by the HIPAA Privacy Rule, prohibits covered entities (such as respiratory disease registries) from disclosing individual health information about a person without his or her written, informed consent. The rule is qualified by exceptions, including mandatory reporting of respiratory diseases to public health authorities and the conduct of research by approved parties.

Discussion

Current methods of studying the geography of the disease include mapping, statistical analysis, simulation, and qualitative analysis. The most basic of exploratory methods is likely the mapping of a selected health statistic (e.g. a mortality rate) by a selected geographic unit, such as the county or census tract. These choropleth maps make use of discrete, bounded units and have been criticized for several reasons. Disease burdens do not adhere to borders of administrative units, and thus, the presentation of disease maps based on these units is ...