Szecsenyi J, Klingenberg A, Pelz J, Magdeburg K
AQUA-Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen, Göttingen.
Z Arztl Fortbild Qualitatssich. 2001 Jul;95(6):407-12.
In the "medical-quality network Ried", an independent practice network in the south of Hessia, an A 4 format patient held record for multi-morbid chronically ill patients is used since 1997. 655 patients (response-rate 71.0%) from sixteen general practitioner (GP) practices were surveyed by written questionnaire. Respondents were in average 68.1 years of age, and for 16.3 years with their GP. 52.2% were male. Patients had their own records for 24.2 months and had in average 1.9 (women) or 2.3 (men) serious health problems. Women had in average 5.0, men had 4.8 different drugs prescribed. 96.7% of the respondents thought that the patient-held record is a good idea, 85.5% felt more secure and 98.7% have it always at hand at home. The patient-held record provides better information about ones own health (92.1%) and 96.6% want to be able to look at their own record. The patient-held record makes it easier for patients to talk to doctors (86.6%) and provides a better overview for the GP (90.8%). The more drugs patients have to take, the more important it becomes for them to have their own record. 68.6% take the record on holyday, 57% take it to other doctors than the GP. 76.4% reported that the patient-held record was used at least once by a specialist, 61.3% by a hospital. 21.8% remembered emergency situations where it was helpful. Only 4.8% thought that it is tiresome. Few proposals for improvement were made, mainly focussing on a smaller format. On the basis of these results patient-held records should be a core activity of practice networks, especially for this type of patients.
在黑森州南部的一个独立执业网络“里德医疗质量网络”中，自1997年起就开始使用一种A4格式的患者持有的多病种慢性病患者记录。通过书面问卷对来自16个全科医生诊所的655名患者（回复率71.0%）进行了调查。受访者平均年龄为68.1岁，与他们的全科医生已有16.3年的医患关系。52.2%为男性。患者拥有自己的记录已有24.2个月，平均有1.9个（女性）或2.3个（男性）严重健康问题。女性平均有5.0种、男性有4.8种不同的处方药。96.7%的受访者认为患者持有记录是个好主意，85.5%感觉更安心，98.7%在家中总是将其放在手边。患者持有记录能提供关于自身健康的更好信息（92.1%），96.6%的患者希望能够查看自己的记录。患者持有记录使患者与医生交流更容易（86.6%），并为全科医生提供了更好的总体情况（90.8%）。患者必须服用的药物越多，拥有自己的记录对他们就越重要。68.6%的患者在节假日带上记录，57%的患者会将其带给全科医生以外的其他医生。76.4%的患者报告说专科医生至少使用过一次患者持有记录，61.3%的患者报告说医院使用过。21.8%的患者记得在紧急情况下它很有帮助。只有4.8%的患者认为它很麻烦。很少有人提出改进建议，主要集中在更小的格式上。基于这些结果，患者持有记录应该成为执业网络的一项核心活动，尤其是对于这类患者。
