患者参与功能对质量结果的影响:通过EHR存在的道路
Soumya Upadhyay, Neeraj Bhandari1
1School of Public Health, University of Nevada, Las Vegas, Nevada.
概括
通过电子健康记录 (EHR) 系统促进患者参与自我护理,可以降低急性心肌梗塞再入院率. 这凸显了医疗IT在改善医疗保健质量和患者结果方面的潜力.
科学领域:
- 医疗信息学 医疗信息学
- 改善医疗保健质量 改善医疗保健质量
- 患者参与技术的技术
背景情况:
- 通过信息技术吸引患者越来越被认为是提高医疗保健质量的策略.
- 电子健康记录 (EHR) 系统提供功能,可以支持患者参与自我护理.
- 降低住院再接收率是改善医疗保健质量和效率的关键目标.
研究的目的:
- 研究电子健康记录 (EHR) 系统功能在患者参与和医疗保健质量结果之间的关系中的调解作用.
- 具体来说,研究患者参与对医院再入院率的影响,重点关注急性心肌梗塞 (AMI),肺炎和心力衰竭.
主要方法:
- 一个综合的横截面研究设计,利用2014年至2018年期间来自3,547家一般急症医院的数据.
- 评估了患者参与功能 (独立变量) 和EHR存在 (介导变量).
- 对AMI,肺炎和心力衰竭的再入院平均时间作为依赖变量,使用Baron和Kenny方法测试调解.
主要成果:
- 患者的参与与较低的AMI再入院率直接相关,并且还通过EHR系统的存在来调解.
- 通过电子病历系统增加1个单位的患者参与率与AMI再入院率下降0.33%相关 (p < .05).
- 对于心力衰竭或肺炎再入院率,没有观察到显著的调解效应.
结论:
- 综合的EHR系统,当利用患者参与时,可能会降低AMI等特定疾病的再入院率.
- 需要进一步的研究来确定其他从患者参与策略中受益的临床条件.
- 患者参与工具和EHR基础设施之间的协同效应可以积极影响医疗保健质量,倡导战略性使用IT投资.
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