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Healthcare environments are creating large databases and repositories, but various healthcare groups are struggling to collect data and build a case for support to collect data that document the contributions of different skill levels and types of healthcare professionals and nonprofessionals.

Jacox (1992) addressed the relevance of this issue for nursing, and noted that databases are needed to clearly distinguish care delivered by individual and/or groups of nurses.

This paper will propose those multiple levels of nursing vocabulary, classifications, and taxonomies that will be needed in the future.

A model will be presented to demonstrate that multiple vocabularies, classifications and taxonomies are needed, convergence is necessary at a certain level, and that a unicode or unified taxonomy is required if global, international, worldwide, or universal comparisons of nursing care are to be made.

The use of vocabulary in nursing is a relatively new phenomenon.

Further, "bad data" may be one of the reasons that health care expenditures are expected to rise in the future: the costs of data collection and health information system development or redesign can be prohibitive if both direct and indirect costs are considered, and the burden of those costs likely will be passed on to individuals, communities, and society.For example, certain funds are released to states in the form of block grants.Medicaid, the joint federal and state program aimed at providing health care coverage to the poor, provides shared reimbursement from federal and state governments, the largest proportion of which comes from state sources.Data for making health care decisions are deficient, not simply because of an insufficient of data.Existing data consists of large amounts of claims data, some administrative and clinical data, and minimal outcomes, quality, and comprehensive cost data.

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