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电子病历的使用与母婴保健

Electronic Medical Record Use and Maternal and Child Care and Health.

作者信息

Meghea Cristian I, Corser William, You Zhiying

机构信息

Institute for Health Policy, College of Human Medicine, Michigan State University, East Lansing, MI, 48823, USA.

Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, East Fee Hall, 965 Fee RD, Room A632B, East Lansing, MI, 48824, USA.

出版信息

Matern Child Health J. 2016 Apr;20(4):819-26. doi: 10.1007/s10995-015-1912-x.

Abstract

OBJECTIVES

To evaluate effects of EHR adoption and use during pregnancy on maternal and child health care utilization and health among pregnant mothers and their infants.

METHODS

The study population was comprised of all Medicaid-insured pregnant women who delivered a singleton birth in Michigan between 1/1/2009 and 12/31/2012 and their infants (N = 226,558). Linked data included birth records, maternal and infant medical claims, and EHR adoption, implementation, upgrading and meaningful use data. Pre-post comparisons with a control group (difference-in-difference) took advantage of a natural experiment of EHR adoption and use among providers in Michigan. Women and infants who received care from providers who adopted and used EHR were compared with those who received care from other providers, in a quasi-experimental framework.

RESULTS

Over 34 % of all women in the analytic sample received perinatal care from providers who adopted and used EHR. Multivariate regressions indicate that women who received prenatal care mainly from a provider who adopted and used EHR were more likely to have any well-child visits (0.05, p = 0.04), and the appropriate number of well-child visits during the first year of life (0.03, p < 0.01).

CONCLUSIONS

The findings of this study are consistent with EHR adoption and use supporting improved child health care utilization. The findings have the potential to provide Medicaid and other healthcare program officials with evidence of the potential gains to be derived from EHRs for vulnerable low-income women and infants.

摘要

目的

评估孕期采用和使用电子健康记录(EHR)对孕妇及其婴儿的母婴保健利用情况和健康状况的影响。

方法

研究人群包括2009年1月1日至2012年12月31日期间在密歇根州单胎分娩的所有参加医疗补助计划的孕妇及其婴儿(N = 226,558)。关联数据包括出生记录、母婴医疗索赔以及EHR的采用、实施、升级和有效使用数据。与对照组进行前后比较(差异中的差异)利用了密歇根州医疗服务提供者采用和使用EHR的自然实验。在一个准实验框架中,将接受采用和使用EHR的医疗服务提供者护理的妇女和婴儿与接受其他医疗服务提供者护理的妇女和婴儿进行比较。

结果

分析样本中超过34%的妇女接受了采用和使用EHR的医疗服务提供者的围产期护理。多变量回归表明,主要从采用和使用EHR的医疗服务提供者那里接受产前护理的妇女更有可能进行任何一次儿童健康检查(0.05,p = 0.04),并且在生命的第一年进行适当次数的儿童健康检查(0.03,p < 0.01)。

结论

本研究结果与采用和使用EHR支持改善儿童保健利用情况一致。这些发现有可能为医疗补助计划及其他医疗保健项目官员提供证据,证明EHR可为弱势低收入妇女和婴儿带来潜在益处。

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