Hsiao Chun-Ju, Marsteller Jill A, Simon Alan E
1National Center for Health Statistics, Hyattsville, MD.
Am J Med Qual. 2014 Jan-Feb;29(1):44-52. doi: 10.1177/1062860613483870. Epub 2013 Apr 22.
The effect of electronic medical records (EMRs) on quality of care in physicians' offices is uncertain. This study used the 2008-2009 National Ambulatory Medical Care Survey to examine the relationship between EMRs features and quality in physician offices. The relationship between selected EMRs features and 7 quality measures was evaluated by testing 25 associations in multivariate models. Significant relationships include reminders for guideline-based interventions or screening tests associated with lower odds of inappropriate urinalysis and prescription of antibiotics for upper respiratory infection (URI), prescription order entry associated with lower odds of prescription of antibiotics for URI, and patient problem list associated with higher odds of inappropriate prescribing for elderly patients. EMRs system level was associated with lower odds of blood pressure check, inappropriate urinalysis, and prescription of antibiotics for URI compared with no EMRs. The results show both positive and inverse relationships between EMRs features and quality of care.
电子病历（EMR）对医生办公室医疗质量的影响尚不确定。本研究利用2008 - 2009年国家门诊医疗调查，来检验电子病历特征与医生办公室医疗质量之间的关系。通过在多变量模型中测试25种关联，评估了选定的电子病历特征与7种质量指标之间的关系。显著关系包括基于指南的干预或筛查测试提醒，这与不适当的尿液分析几率降低以及上呼吸道感染（URI）使用抗生素处方几率降低相关；处方订单录入，这与URI使用抗生素处方几率降低相关；以及患者问题列表，这与老年患者不适当处方几率升高相关。与无电子病历相比，电子病历系统水平与血压检查、不适当尿液分析以及URI使用抗生素处方几率降低相关。结果表明电子病历特征与医疗质量之间存在正向和反向关系。
