Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA Graduate College of Social Work, University of Houston, Houston, Texas, USA.
Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
J Am Med Inform Assoc. 2014 Jul-Aug;21(4):737-41. doi: 10.1136/amiajnl-2013-002239. Epub 2013 Oct 23.
We conducted a systematic review to determine the effect of providing patients access to their medical records (electronic or paper-based) on healthcare quality, as defined by measures of safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity.
Articles indexed in PubMed from January 1970 to January 2012 were reviewed. Twenty-seven English-language controlled studies were included. Outcomes were categorized as measures of effectiveness (n=19), patient-centeredness (n=16), and efficiency (n=2); no study addressed safety, timeliness, or equity.
Outcomes were equivocal with respect to several aspects of effectiveness and patient-centeredness. Efficiency outcomes in terms of frequency of in-person and telephone encounters were mixed. Access to health records appeared to enhance patients' perceptions of control and reduced or had no effect on patient anxiety.
Although few positive findings generally favored patient access, the literature is unclear on whether providing patients access to their medical records improves quality.
我们进行了一项系统评价,以确定为患者提供获取其病历(电子或纸质)的机会对医疗质量的影响,医疗质量由安全性、有效性、以患者为中心、及时性、效率和公平性等方面的衡量标准来定义。
我们对 1970 年 1 月至 2012 年 1 月期间在 PubMed 上索引的文章进行了回顾。纳入了 27 项英语对照研究。研究结果分为有效性(n=19)、以患者为中心(n=16)和效率(n=2)的衡量标准;没有研究涉及安全性、及时性或公平性。
就有效性和以患者为中心的几个方面而言,研究结果存在分歧。就面对面和电话就诊的频率而言,效率方面的结果喜忧参半。获取健康记录似乎增强了患者的控制感,降低了或没有降低患者的焦虑感。
尽管少数积极发现通常有利于患者获得医疗记录,但文献尚不清楚为患者提供获取其医疗记录的机会是否能提高医疗质量。