# HLT 362 Discuss the historical application of statistics in the field of health care

## Topic 1 DQ 1

Discuss the historical application of statistics in the field of health care. Describe an example, other than Florence Nightingale’s contributions, where statistical application has greatly influenced or changed health care operations or practice.

## History of Statistics

Statistics is not a newly developed concept when it comes to looking for answers. In fact, it has been around for hundreds of years. “The roots of nursing practice are based on the use and statistical analysis of patient data” (Ambrose et al., 2022). Health statistics provide data to assist in the allocation of public as well as private funds. Statistics also enable the understanding of population characteristics, for example, disease mortality rates, morbidity or prevalence, and even quantification of health disparities. Previous scholars such as Florence Nightingale have impacted the health industry through the use of statistics to demonstrate needed healthcare initiatives.

## Example of Statistical Application in Healthcare

Because of how complex the human body, and mind are, and the ways in which all of these aspects interact with their surroundings, statisticians and nursing researchers need to work together on a continuous basis. Sir Edwin Chadwick (1800-1890) had written a report in 2842 on the sanitary conditions among the laboring population in Great Britain. “Edwin demonstrated the existence of a mass of preventable illnesses and premature death in the community caused, he argued, by unsanitary physical circumstances” (Green et al., 2018). The painstaking documentation of statistical evidence written in his report about the social and spatial inequalities in health and unsanitary conditions is one of the earliest (1824) examples of providing evidence-based health advice to the public. His findings provided the foundation for advances made later on by figures such as William Farr (Green et al., 2018).

## References

Ambrose, J., Helbig, J., Ryan, C., & Torres, E. (2022). Applied Statistics for Healthcare (Second Edition ed.). Grand Canyon University. https://bibliu.com/app/#/view/books/1000000000581/epub/Chapter1.html#page_8

Green, M. A., Dorling, D., & Mitchell, R. (2018, January). Updating Edwin Chadwick’s seminal work on geographical inequalities by occupation. National Library of Medicine, 59-62. 10.1016/j.socscimed.2017.11.055

## Title: HLT 362 Discuss the historical application of statistics in the field of health care

Statistics have been in used in the field of healthcare for a very long-time. They have been used in planning and improving healthcare activities as well as allocating resources to be used. Statistics were also used in healthcare to analyze research data, laboratory results, outcomes of treatment and the epidemiology of some condition (Health statistics: Past, present, and future – Toward a health statistics system for the 21st century – NCBI bookshelf, n.d.). With the statistical data, there has been significant improvement in the quality of care delivered and safety of patients since previous data inform the current practice on what to do and what to avoid. Use of statistics has been applied in preventing and managing infections in care facilities. Statistical methods such as rates, ratios and proportions have been used to present data concerning infections in care

facilities hence informing the stakeholders on the appropriate methods of

minimizing the cases (Basic statistics for infection Preventionists, 2019).

## References:

Health statistics: Past, present, and future – Toward a health

statistics system for the 21st century – NCBI bookshelf. (n.d.). National

Center for Biotechnology

Information. https://www.ncbi.nlm.nih.gov/books/NBK223602/

Basic statistics for infection Preventionists. (2019, February

## Title: HLT 362 Discuss the historical application of statistics in the field of health care

The historical application of statistics has been used in healthcare for many years to analyze data and create and utilize evidence-based practice. Evidence-based practice is important because it helps improve patient outcomes and quality of life (Helbig, & Ambrose, 2018). As we know nurses and other healthcare professionals use data from the statistics. As we know, Nightingale contributed to statistics on injuries, infection, and insanitary conditions, gathered that data and used it to help improve infection rates, mortality rates, and decrease injuries. Edwin Chadwick has greatly influenced health care practice when he appointed the poor sanitations. He used statistics to help improve sanitary conditions in turn improving individuals’ quality of life. Clara Barton was also a nurse who focused on the quality of life and health of the public. She used the application of statistics to change health cate by establishing the red cross, building data on the thousands of people homeless and helped raise money, food and supplies to aid survivors (Bolick, 2021).

## Reference

Bolick , K. (2021, December 1). Clara Barton epitomized the heroism of Nurses. Smithsonian.com. Retrieved January 31, 2023, from https://www.smithsonianmag.com/history/clara-barton-hero-nurse-180979006/

Helbig, J. & Ambrose, J. (2018). Applied Statistics for Health Care. https://www.gcumedia.com/digital-resources/grand-canyon- university/2018/applied-statistics-for-health-care_1e.php

## Title: HLT 362 Discuss the historical application of statistics in the field of health care

In the era of technological trends, extensive statistics have been broadly carried out in diverse businesses, especially healthcare. An extensive amount of data has unfolded new gaps in fitness care. The immense facts in healthcare have the capability to improve healthcare to a higher level. Significant records can correctly lessen healthcare problems such as the selection of the appropriate remedy, and solution for healthcare, and enhancing the healthcare machine. There are six defining attributes in extensive data, namely, extent, range, speed, veracity, variability, complexity, and value. Massive information represents an expansion of possibilities that could enhance the performance of healthcare. The extensive data in healthcare should help in the advanced use of huge data analytics to gain valuable know-how. This powerful information analytics is used to get valuable facts from all types of sources in healthcare that may be used to take advantage of the data in order to make a better choice in healthcare. Massive information analytics can enhance health care by discovering institutions and expertise styles and trends in scientific facts. Cardiovascular disorder datasets are massive data in healthcare, and they are used as part of facilitating the system of documenting scientific facts that must be analyzed to offer powerful answers to troubles in fitness care. This paper provides valuable statistics by using massive information analytics from clinical statistics of cardiovascular disease to provide convincing answers for the troubles in healthcare and also to indicate how huge information is essential for healthcare. with statistics participation, we can manage the healthcare base and balance.

Kurniasari F, Hamid NA, Qinghui C. The effect of perceived usefulness; perceived ease of use, trust, attitude, and, satisfaction into a continuance of intention in using Alipay. Management & Account Review. 2020;19(2):131–150.

http://dx.doi.org/10.24191/mar.v19i2.1190

Zhang Y, Qiu M, Tsai CW, Hassan MM, Alamri A. Health-CPS: Healthcare cyber-physical system assisted by cloud and big data. IEEE Syst J. 2017;11(1):88–95. https://doi.org/10.1109/JSYST.2015.2460747

## Title: HLT 362 Discuss the historical application of statistics in the field of health care

The application of statistics in health care dates back to the days of Florence Nightingale. While her contributions using statistical analysis was monumental, it was the just beginning of analyzing data to improve patient outcomes (Helbig & Ambrose, 2021). Upon the development of the Communicable Disease Center or what we now know as the Centers for Disease Control and Prevention (CDC) in 1946, the U.S. Public Health service employed the same strategies used by Nightingale and others to develop their own statistical methods. This eventually led to the creation of the Epidemic Intelligence Service (EIS) whose purpose was to respond to and investigate outbreaks and further advance epidemiologic methods. Through continued research with evolving methods and calculations based on best-evidence available at the time, the CDC was able to identify many hazardous health conditions that significantly contributed to the morbidity and mortality of the population. These advances include banning the use of lead in gasoline after the EPA developed a method in which blood lead levels could be detected and measured.

This act alone helped to decrease the rates of lead exposure, and the adverse effects that follow. As the methods and application of statistics continued to improve and become more refined, epidemiologists were able to incorporate technology as seen with the use of the SOCRATES program in 1976, a development that enabled a more efficient way for scientists to address the swine flu crisis of the time (Stroup & Lyerla, 2011). As technology continues to evolve, so too will the application of its uses across health care statistics, allowing for larger sample sizes, more accurate calculations and higher quality of studies. These continued advancements are necessary to address the ongoing threats of disease and serve as pillars for innovating new and creative methods of health promotion and disease prevention.

## Reference

Helbig, J. & Ambrose, J. (2021). What are statistics and why are they important to health science? In Grand Canyon University (Ed.), Applied statistics for health care (ch.1). https://bibliu.com/app/#/view/books/1000000000581/epub/Chapter1.html#page_6

Stroup, D.F. & Lyerla, R. (2011). History of statistics in public health at CDC, 1960–2010: The rise of statistical evidence. Morbidity and mortality weekly report 60(04), 35-41. https://www.cdc.gov/mmwr/preview/mmwrhtml/su6004a7.htm

## Title: HLT 362 Discuss the historical application of statistics in the field of health care

Statistics has been used in the health care field for centuries, beginning with the contributions of Florence Nightingale in the mid 1800s. Since then, statistics have been used to better understand and improve patient care. One example of this is the use of statistical process control (SPC) in health care. SPC is a data-driven method of monitoring and controlling processes, and has been used in the health care field since the 1970s. SPC has been used to measure and improve the quality of care and patient outcomes, as well as to monitor and reduce medical errors and costs.

More recently, statistics has been used to understand and analyze health care data from sources such as electronic health records (EHRs). This data can be used to understand trends in patient care and outcomes, and to identify gaps in care, such as inadequate access to care for certain patients or populations. This data can also be used to inform decisions about care and to improve patient outcomes. For example, a recent study published in the Journal of the American Medical Informatics Association found that the use of EHR data to identify and intervene in high-risk patients with diabetes was associated with improved patient outcomes (Ahmed et al., 2020).

In conclusion, statistics has been used in the health care field for centuries, and has significantly improved patient care and outcomes. From SPC to the use of EHR data, statistics has been used to measure and improve the quality of care, reduce medical errors and costs, and inform decisions about care.

## References

Ahmed, A. M., Zhao, Y., Hong, Q., Yoon, S. L., & Zheng, J. (2020). Impact of using electronic health record data to identify and intervene in high-risk patients with diabetes. Journal of the American Medical Informatics Association, 27(3), 355-363. https://doi.org/10.1093/jamia/ocaa029

## Title: HLT 362 Discuss the historical application of statistics in the field of health care

Using statistics in making healthcare decisions had evolved overtime having a positive impact on care delivery and patient outcome. The data collected is used for research, quality improvement, inequalities in healthcare, risk analysis, inventory management and cost, resource utilization, patient length of stay analysis, patient satisfaction, clinical trials, morbidity and mortality, effects of new treatments, measuring change, laboratory analysis, education, and much more. In the 19th century, Edward Ballard a British physician was part of a group of influential epidemiologists who studied infectious disease exploring some of the most important environmental and health-related problems in preventive medicine. The research focused on the course, spread, and eradication of typhoid fever and industrial health (Jacob, 2018).

The COVID-19 is an excellent example of how statistics are not only impacting the health care but impacting every aspect of life and the entire globe. Presently our ability to live a normal life is now decided by the government. The passionate hunt for a vaccine is flashed on television, newspapers, and magazines daily. In the US, government agencies, healthcare professionals and other stakeholders watch the statistics on new cases exposure to determine (PUI) and death toll in cities, county, state or entire national. These daily statistics decide whether our children attend school in person, if a patient is allowed to have a family member at the bedside during hospitalization, engage in religious or social activities in person, and many more. Our world is functioning on the positivity percentage on any given moment. Daily we are inundated with discussions of what therapeutic modalities are the most effective and the timing of their use. No aspect of health care has not been impacted by the statistics associated with COVID-19.

According to Helbig & Ambrose (2018), data analysis creates the future of healthcare. As healthcare providers, the ability to understand the data, its application, validity and usability to improve health outcomes of patients is an essential skill.

## REFERENCES

Helbig, J. & Ambrose, J. (2018). Applied Statistics for Health Care. https://www.gcumedia.com/digital-resources/grand-canyon- university/2018/applied-statistics-for-health-care_1e.php

Jacob, S. (2018). Edward Ballard and the Practice of Epidemiology in the 19th-Century United Kingdom. American Journal of Public Health. https://doi.org/10.2105/AJPH.2018.304692

## Title: HLT 362 Discuss the historical application of statistics in the field of health care

Statistical application has greatly influenced health Statistics to provide information for understanding, monitoring, and the resources to improve the lives of people, provide services and promote their well-being. Statistics are used in healthcare for research, quality improvement, inequalities in healthcare, risk analysis, inventory management, cost, resource utilization, patient length of stay, patients satisfaction, clinical trials, morbidity and mortality, effects of new treatments, measuring change, laboratory analysis, education, and much more.

Evidence-based medicine aims to improve health care and reduce costs through the use of sound clinical evidence in evaluating treatments, procedures, and outcomes. The field is hardly new, however, and most trace its origins back to the work of Cochrane in the 1970s and Sackett in the 1990s. Though she wouldn’t know it, Florence Nightingale was applying the concepts of evidence-based reform to the medical profession more than a century before. She used medical statistics to reveal the nature of infection in hospitals and on the battlefield. Moreover, Nightingale marshaled data and evidence to establish guidelines for healthcare reform. Tracing the origins of evidence-based medicine back to Nightingale underscores how critical this movement is to improve the quality and effectiveness of patient care today.

Nightingale believed that using evidence from statistics would enable healthcare providers to achieve better care in a more efficient, economical manner. In her Notes on Hospitals, she wrote, “With fixed data…we can readily obtain the proportionate mortality, not only of the whole hospital, but of every ward of it, and also the proportionate mortality and duration of cases for each age, sex, and disease. These methods, if generally used, would enable us to ascertain the mortality in different hospitals, as well as from different diseases and injuries at the same time and at different ages, the relative frequency of different diseases and injuries among the classes which enter hospitals in different countries, and in different districts of the same country. They would enable us to ascertain how much each year of life is wasted by illness—what diseases and ages press most heavily on the resources of particular hospitals. She raised many points that are currently debated regarding the use of evidence-based medicine, such as quality of care as it relates to the use of hospital resources, the cost of treatment .and cost-benefit analyses, all from a nationwide standpoint.

## References

Kudzma EC. Florence Nightingale and healthcare reform. Nurs Sci Q. 2006;19:61–64.

Sieber WK, Green TA, Haugh GS, et al., eds. Symposium on emerging statistical issues in public health for the 21st century, Stat Med 2001;20:1307–561.

Lin LS, Conn JM, Green TA, Johnson CH, Odencrantz JR, Sieber WK Jr, eds. 8th Biennial CDC and ADSTR Symposium on Statistical Methods: issues associated with complicated designs and data structures. Stat Med 2003;22:1359–626.

Davis KE, O’Connor KS, eds. Statistical issues in addressing health inequalities. Stat Med 2008;27:3925–4144.

Utilization of multi-source data: InfoFusion. Available at http://www.cdc.gov/sag.

## Title: HLT 362 Discuss the historical application of statistics in the field of health care

The healthcare field is centered around collecting, analyzing, interpreting, and presenting data (Statology, 2022). Statistics is important when it comes to healthcare because it allows providers to monitor the health status of individuals by using trends and other descriptive statistical factors. In the same context, using statistics is how healthcare professionals are able to determine the relationship between variables using regression models. We all may think we don’t use statistics, but we do each day without realizing that is what we are doing! Health statistics typically measure four types of information that are commonly referred to as the four C’s: conditions, care, correlations, and costs (NIH, 2020). Conditions refers to how a community is impacted by disease, care determines how healthcare services are delivered to the community, correlations measure the risk factors and preventative measures that impact health status, costs gather information on the costs of services and the rationale behind the cost.

Statistical application greatly influenced healthcare practice in the year 1971, when the National Center for Health Statistics, which was not yet a part of the Centers for Disease Control (CDC), conducted the first NHANES assessment, which is a National Health Assessment and Nutrition Examination Survey (CDC, 2018). This was a revolutionary time in terms of statistical data in healthcare. Nowadays, it is difficult to imagine an epidemiological investigation without a 2×2 table, p value, or odds ratio. This is due to the fact that statistical values are needed to understand methods of caring for the public health. Things such as disease, more of transmission, and appropriate protection measures to prioritize activities.

## References

CDC. (2018). Morbidity and mortality weekly report (MMWR). Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/preview/mmwrhtml/su6004a7.htm

NIH. (2020). About health statistics. U.S. National Library of Medicine. https://www.nlm.nih.gov/nichsr/stats_tutorial/section1/index.html

Statology. (2022, October 1). Welcome to statology. Statology. https://www.statology.org/

## Title: HLT 362 Discuss the historical application of statistics in the field of health care

Data-driven statistics were traditionally used to identify patient care trends and develop and utilize evidence-based practices to improve patient outcomes and ensure quality care. (Ambrose. 2018). Mathematical statistics have been used in health care to analyze data. Statistics contributed to the development of methods, directions, and results. Epidemiology was developed through data analysis. Currently, because of this rich development, the enormous amount of health care data collected from electronic medical records can help answer questions through data analysis. This includes biostatistics, satisfaction surveys, birth weights, mortality rates, diagnoses, and testing results.

Statistics aid birth epidemiology. The use of mathematical methods and statistics in epidemiology and public health is essential to identifying disease causes, transmission modes, control and prevention measures, and prioritizing and evaluating activities (Stroup, 2011). The use of data facilitates policy making, planning, and evaluation. During the 20th century, routine immunization of children was an example of how the application of statistics has greatly influenced or changed health care operations and practices. A number of vaccines have been developed by researchers in the health care field in order to prevent diseases such as Covid 19, chicken pox, measles, polio, and others. A statistically designed clinical trial and a statistical quality control process are usually used to determine the safety and efficacy of these lifesaving vaccines.

## References

Ambrose, J. (2018). What are Statistics and why they are important to The Health Science are. In Applied Statistics for Health Care.  Retrieved from https://lc.gcumedia.com/hlt362v/applied-statistics-for-health-care/v1.1/#/chapter/1

Stroup, D. F. (2011). History of Statistics in Public Health at CDC, 1960-2010: The Rise of

## Title: HLT 362 Discuss the historical application of statistics in the field of health care

Statistics is a broad term that refers to numerical data gathered through measurements or observations of a certain phenomenon, organization, or population sample. Statistics can be used for a range of purposes, from giving descriptive features to monitoring performance results (History of Statistics in Public Health, 2022). Health Statistics provide information for understanding, monitoring, improving and planning the use of resources to improve the lives of people, provide services and promote their well-being. Numerical data is widely used in health care because of its objectivity and ability to provide data-driven strategies that can maximize efficiency and measure the health of large populations (NIH, 2020). Florence Nightingale used a statistical approach to decrease the mortality rate of British troops in Crime. In 1854, Florence and 38 nurses set out for a British military hospital on the outskirts of Constantinople to care for British service members (Dhillon et al, 2022). Florence visited the colonies and saw how soldiers were dumped on the ground, and doctors struggled to treat them in a dirty, undeveloped hospital with no supplies. She also kept track of the mortality rate at the hospital using her mathematical knowledge. According to the statistics, 600 out of every 1,000 injured troops died from infectious diseases (Dhillon et al, 2022). She was a pioneer in the gathering, compilation, analysis, and graphical presentation of descriptive and inferential statistics because of her meticulous records.

Health care organizations increasingly often utilize statistical analysis to monitor their development. Hospitals and other large service providers use data-driven efforts to operate as efficiently as possible. Statistics are frequently used for quality measurement and improvement, as well as for systematic process control (NIH, 2020). Data on performance and quality indicators is gathered over time and examined to identify specific trends or responses to initiatives.

## References

Dhillon, S. K., Ganggayah, M. D., Sinnadurai, S., Lio, P., & Taib, N. A. (2022). Theory and Practice of Integrating Machine Learning and Conventional Statistics in Medical Data Analysis. Diagnostics (2075-4418)12(10), 2526–N.PAG. https://doi-org.lopes.idm.oclc.org/10.3390/diagnostics12102526

History of Statistics in Public Health at CDC 1960-2022: The Rise of Statistical Evidence. Retrieved January 31, 2023, from https://www.cdc.gov/mmwr/preview/mmwrhtml/su6004a7.htm

National Library of Medicine (NIH). (2020). Finding and Using Statistics. About Health Statistics. Retrieved January 31, 2023, from https://www.nlm.nih.gov/nichsr/stats_tutorial/section1/index.html#:~:text=Health%20statistics%20are%20used%20to,that%20can%20support%20a%20conclusion