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服务不足人群患者群体和基层医疗机构医生采用电子病历系统。

Patient panel of underserved populations and adoption of electronic medical record systems by office-based physicians.

机构信息

Department of Pharmacy Practice, Division of Pharmaceutical Evaluation and Policy, College of Pharmacy, University of Arkansas for Medical Sciences, 4301 W. Markham Street Slot # 522, Little Rock, AR 72205, USA.

出版信息

Health Serv Res. 2010 Aug;45(4):963-84. doi: 10.1111/j.1475-6773.2010.01113.x. Epub 2010 Apr 9.

Abstract

OBJECTIVES

To examine the association between patient panels of underserved populations and adoption of electronic medical records (EMRs) among office-based physicians.

DATA SOURCES

Two thousand three hundred and twenty-six office-based physicians who responded and saw patients in the 2005 and 2006 National Ambulatory Medical Care Surveys.

STUDY DESIGN

This study used a cross-sectional design. The unit of analysis was the office-based physician. EMR adoption was defined based on functionalities (No EMR, Limited, or Comprehensive). An EMR was considered to have "comprehensive" functionalities if it included computerized orders for prescriptions and tests, test results, and clinical notes by physicians. Patient panels of underserved populations were measured as proportions of racial/ethnic minorities, Medicaid recipients, or self-pay/no charge/charity care patients treated by a physician using the reported sociodemographic characteristics in patient records linked to their treating physicians. Data were analyzed using multivariate regression analyses controlling for other patient-panel characteristics and characteristics of physicians and their practices.

PRINCIPAL FINDINGS

We found a negative association between the proportion of Hispanics treated by a physician and physician adoption of EMRs with "comprehensive" functionalities after adjusting for other covariates.

CONCLUSIONS

Physicians treating high shares of Hispanic patients may have lower access to EMRs with essential functionalities.

摘要

目的

考察服务不足人群患者群体与基层医疗机构医生采用电子病历(EMR)之间的关联。

数据来源

在 2005 年和 2006 年全国门诊医疗调查中,有 2326 名基层医疗机构医生做出回应并为患者看病。

研究设计

本研究采用横断面设计。分析单位为基层医疗机构医生。根据功能(无 EMR、有限或全面)来定义 EMR 的采用情况。如果 EMR 包括计算机开方、检验申请、检验结果和医生临床记录,则被认为具有“全面”功能。利用患者记录中报告的社会人口学特征,将服务不足人群患者群体定义为医生所治疗的少数族裔/少数民族、医疗补助受助人或自费/免费/慈善护理患者的比例。通过多变量回归分析,在控制其他患者群体特征以及医生和其行医特征后,对数据进行分析。

主要发现

在调整其他协变量后,我们发现医生所治疗的西班牙裔患者比例与医生采用具有“全面”功能的 EMR 之间呈负相关。

结论

治疗大量西班牙裔患者的医生可能无法获得具有基本功能的 EMR。

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