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患者阅读其病历的意愿:与临床及社会人口学特征的关系以及患者的医疗保健方式

Patients' interest in reading their medical record: relation with clinical and sociodemographic characteristics and patients' approach to health care.

作者信息

Fowles Jinnet B, Kind Allan C, Craft Cheryl, Kind Elizabeth A, Mandel Jeffrey L, Adlis Susan

机构信息

Health Research Center, Park Nicollet Institute, and Park Nicollet Health Services, Minneapolis, Minn, USA.

出版信息

Arch Intern Med. 2004 Apr 12;164(7):793-800. doi: 10.1001/archinte.164.7.793.

DOI:10.1001/archinte.164.7.793
PMID:15078650
Abstract

BACKGROUND

Although opportunities for patients to review their medical records are increasing, nothing is known about which patients want to take advantage of those opportunities. The objective of this study was to determine the proportion and characteristics of patients who are very interested in examining their clinic medical record and the reasons for their interest.

METHODS

Cross-sectional, mailed survey (conducted in May 2001) to a random sample of 4500 adults who had a recent clinic visit.

RESULTS

The response rate was 81%; 36% were very interested in reading their medical record (dependent variable). In multivariate logistic regression, the significantly related factors were seeking health information (finding the Internet very important for health information [adjusted odds ratio, 2.09], having a health newsletter subscription [adjusted odds ratio, 1.23], and using a health resource book in last month [adjusted odds ratio, 1.36]); being very concerned about errors in care (adjusted odds ratio, 2.52); and lacking trust in their physician (adjusted odds ratio, 1.55). Health status, use of health care, education, and income were not independently related to patients' interest. The most common reasons for patients wanting to look at their medical record were to see what their physician said about them (74%), to be more involved in their health care (74%), and to understand their condition better (72%).

CONCLUSIONS

Patients' interest in reading their medical record is better predicted by their consumer approach to health care than it is by their clinical characteristics. Demographic characteristics of sex and race were related, while socioeconomic factors of education and income were not.

摘要

背景

尽管患者查看其病历的机会在增加,但对于哪些患者想要利用这些机会却一无所知。本研究的目的是确定对查看其门诊病历非常感兴趣的患者比例和特征,以及他们感兴趣的原因。

方法

于2001年5月对4500名近期有门诊就诊经历的成年人进行随机抽样的横断面邮寄调查。

结果

回复率为81%;36%的患者对阅读其病历非常感兴趣(因变量)。在多因素逻辑回归分析中,显著相关的因素包括寻求健康信息(认为互联网对健康信息非常重要[调整后的优势比为2.09]、订阅健康通讯[调整后的优势比为1.23]以及上个月使用健康资源手册[调整后的优势比为1.36]);非常担心医疗差错(调整后的优势比为2.52);以及对其医生缺乏信任(调整后的优势比为1.55)。健康状况、医疗保健使用情况、教育程度和收入与患者的兴趣无独立相关性。患者想要查看其病历的最常见原因是想知道医生对他们的评价(74%)、更积极地参与自身医疗保健(74%)以及更好地了解自己的病情(72%)。

结论

与临床特征相比,患者对阅读病历的兴趣通过其对待医疗保健的消费者方式能得到更好的预测。性别和种族的人口统计学特征与之相关,而教育程度和收入的社会经济因素则不然。

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