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电子健康信息交换同意的决定因素:一项观察性回顾性研究
Jelle Keuper1,2, Karin Hek3, Lilian H D van Tuyl3
1Netherlands Institute for Health Services Research, Utrecht, Netherlands. j.keuper@nivel.nl.
Health research policy and systems
|August 7, 2025
概括
荷兰患者对电子健康信息交换 (HIE) 的同意在患有慢性疾病或更高医疗保健需求的人群中较低. 这表明那些可以从HIE中获益最多的人不太可能同意.
科学领域:
- 医疗信息学 医疗信息学
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 电子健康记录 (EHR) 的数据共享提高了医疗保健的质量,效率和患者安全.
- 对于健康信息交换 (HIE) 患者同意是强制性的.
- 荷兰有一个国家患者同意和HIE系统,在一般实践电子健康记录中记录了同意状态.
研究的目的:
- 调查影响患者同意电子HIE的个人和一般实践层面因素.
- 了解COVID-19大流行之前荷兰对HIE的同意模式.
主要方法:
- 来自荷兰一般实践和非工作时间服务 (2017-2019) 的常规电子健康记录数据的分析 (2017-2019).
- 使用了双变量chi-squared和多级逻辑回归分析.
- 检查的因素包括个人健康,医疗保健利用率,人口统计,社区特征和一般实践属性.
主要成果:
- 在2017-2019年期间,38-45%的个人同意电子HIE.
- 慢性病患者,处方数量较高,女性和老年人 (≥65岁) 的同意率较低.
- 贫困城市或几乎没有城市化社区的个人,他们的社会经济地位低于平均水平,他们的同意率更高.
结论:
- 与预期相反,更高的医疗保健利用率与较低或类似的HIE同意率有关.
- 最有可能从HIE中受益的人口可能不太可能参与.
- 需要进一步研究信任,隐私,透明度和医生信仰,以优化HIE系统.
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