A Perinatal Database Management System^[*]

Obstetric services have long recognized the need for ongoing evaluation of their experiences. Manual »departmental statistics« systems sufficed, but with the advent of more sophisticated care, perinatal re-gionalization and increased research activity, the potential usefulness of computer technology became obvious. At Cleveland Metropolitan General Hospital, a laboratory computer based patient information file system was designed and implemented beginning in 1974. Over the succeeding six years, data have been collected and stored for all delivered pregnancies. There are now over 61,000 files for more than 20,000 consecutively delivered patients. The system provides over 40,000 clinical reports per year. However, the use of a file-oriented system has limited our ability to respond to specific research queries. The application of a relational database management system, INGRES, for perinatal information is reported here. Examples of its use for efficiently »answering questions« are presented, as are guidelines for the development and implementation of computer-based perinatal record systems.

In der Geburtshilfe ist die Notwendigkeit einer laufenden Auswertung der klinischen Erfahrungen seit langem erkannt worden. Manuelle statistische Systeme in den Abteilungen genügten zunächst; aber mit dem Aufkommen differenzierterer Versorgung, perinataler Regionalisierung und zunehmender Forschungstätigkeit wurde die potentielle Nützlichkeit der Computertechnik offensichtlich. Im Cleveland Metropolitan General Hospital wurde im Jahre 1974 ein computerunterstütztes Informationssystem für Patientendaten aus dem Laboratorium geplant und implementiert. In den folgenden sechs Jahren wurden Daten über alle Entbindungen gesammelt und gespeichert. Derzeit existieren mehr als 61,000 Krankenbetten für mehr als 20,000 nacheinander entbundene Patientinnen. Das System liefert über 40,000 klinische Berichte pro Jahr. Allerdings hat die Benutzung eines Datei-orientierten Systems unsere Fähigkeit, spezifische Suchanfragen zu beantworten, eingeschränkt.

In der vorliegenden Arbeit wird über die Anwendung eines relationalen Datenbankverwaltungssystems, INGRES, für perinatale Daten berichtet. Es werden Beispiele für seine Verwendung zur gut funktionierenden Beantwortung von Anfragen sowie Richtlinien für die Entwicklung und Implementierung von Compu-ter-unterstützten Berichtssystemen über perinatale Daten beschrieben.

Key-Words:

Perinatal Database - Relational Database - INGRES - Pregnancy Risk

Schlüssel-Wörter:

Perinatale Datenbank - relationale Datenbank - INGRES - Schwangerschaftsrisiko

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