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hospitalization of aged patients in which
they break bones and receive treatments
patient
subject(of the period event)
denominator (segment)
rate of numbers of patients
numerator patients
patient
subject(of the period event)
hospitalization of aged patients
FIGURE 5.9
The quality indicator in Section 1.1.1 expressed with QI-RS.
RELATED WORK
Research of quality indicators has a long history, and one can see a
starting point in Nightingale's work [Nightingale, 1859]. One can see
researches on the ways to define quality indicators in [Donabedian, 1980],
[Mainz, 2003], and [Mainz et al., 2004]. Moreover, in recent years, com-
parison results of quality indicators among multiple hospitals or countries
are seen in [Mainz et al., 2004], [OECD, 2006], and [Mainz et al., 2009].
Though these researches are important for actual definition of quality
indicators for comparison of medical service quality, they have been done
from the viewpoints of epidemiology. On the other hand, because this
chapter focuses on how to describe quality indicators from the viewpoint
of knowledge representation, especially, we focus on a representation of a
quality indicator that satisfies understandability and formality.
Formality and understandability of ontology-based representation
for medical services have been researched in [Huser et al., 2010] and
[Mabotuwana and Warren, 2009]. The later authors propose a framework
to indentify hypertensive patients who satisfy evidence-based criteria for
quality improvement potential. They propose three issues for domain
modeling: (1) shareability, (2) extensibility, and (3) easy visualization of
a knowledge base for domain modeling. On the other hand, [Huser et al.,
2010] establish a query system of an electronic health record data based on
a flowchart that indicates processes to treat patients. The authors propose
a tradeoff problem of readability and expressiveness of query representa-
tion. [Huser et al., 2010] and [Mabotuwana and Warren, 2009] focus on
how to represent queries correctly and/or easily on the basis of consider-
ably restricting the domain of the query, and their approaches are not easy
to extend for evaluation of general medical service quality. This chapter
enhances formality and understandability of QI-RS by MSO that provides
sufficient vocabulary words to define quality indicators and by establish-
ing a general framework of ontology-based graph representation.
For more general medical information, there are a lot of researches for
ontology-based information retrieval, or ontology-based information
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