初级和中等保健之间的数字沟:使用SARS-CoV-2医院入院的分析
Amit Sagi1, Vipin Asopa1, Benjamin Mitchell1
1Department Of Orthopaedic Surgery, South West London elective Orthopaedic Centre and St. Helier University Hospital's NHS Trust, Epsom, UK.
Health informatics journal
|July 24, 2024
概括
从全科医生 (GP-SCR) 那里预先存在的数字健康记录比急诊室 (ED) 数据更好地预测患者因SARS-CoV-2的死亡率. 在ED记录中缺少GP代码与死亡风险增加有关.
科学领域:
- 医疗信息学 医疗信息学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 电子健康记录,包括全科医生 - 简要护理记录 (GP-SCR),包含有价值的患者数据.
- 在初级保健和急救部门 (ED) 收集的数据之间存在差异.
- 了解这些差异对于准确的患者评估和结果预测至关重要,特别是在像SARS-CoV-2流行病这样的公共卫生危机期间.
研究的目的:
- 为了分析国际疾病分类中的差异,第10版 (ICD-10) 编码GP-SCR和ED记录之间的SARS-CoV-2患者的患者记录.
- 为了确定这些代码差异是否与患者死亡率的增加有关.
- 评估先前存在的全科医生数字数据与ED收集的死亡率数据的预测价值.
主要方法:
- 从GP-SCR和ED记录中对773名入院的SARS-CoV-2患者的ICD-10代码进行了回顾性分析.
- 两个数据源之间的代码存在和缺失的比较.
- 统计分析以评估代码差异与死亡结果之间的关系.
主要成果:
- 与幸存者相比,死亡的患者在GP-SCR和ED记录中的ICD-10代码的平均数量显著更高 (p < .0001).
- 观察到重要的代码差异:在ED记录中,多达78.47%的GP-SCR代码遗漏,在GP-SCR中,多达45.49%的ED代码不存在.
- 错过的ICD-10代码的一个子集被确定为预测患者的结果,死亡率的增加与错过的代码的更高比例相关.
结论:
- 预先存在的GP数字数据 (GP-SCR) 与ED中手动收集的数据相比,为SARS-CoV-2患者提供了更好的死亡率预测.
- 解决初级保健和ED之间的数据共享和整合差距对于改善患者护理至关重要.
- 为更广泛的医疗保健社区提供GP-SCR数据的访问,可以增强临床决策和减少机器学习算法开发中的偏见.
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