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加拿大基层医疗实践中的计算机使用情况。

Computer use in primary care practices in Canada.

作者信息

Anisimowicz Yvonne, Bowes Andrea E, Thompson Ashley E, Miedema Baukje, Hogg William E, Wong Sabrina T, Katz Alan, Burge Fred, Aubrey-Bassler Kris, Yelland Gregory S, Wodchis Walter P

机构信息

Research assistant at the Dalhousie Family Medicine Teaching Unit in Fredericton, NB.

New Brunswick SPOR (Strategy for Patient-Oriented Research Network) coordinator in Fredericton.

出版信息

Can Fam Physician. 2017 May;63(5):e284-e290.

Abstract

OBJECTIVE

To examine the use of computers in primary care practices.

DESIGN

The international Quality and Cost of Primary Care study was conducted in Canada in 2013 and 2014 using a descriptive cross-sectional survey method to collect data from practices across Canada. Participating practices filled out several surveys, one of them being the Family Physician Survey, from which this study collected its data.

SETTING

All 10 Canadian provinces.

PARTICIPANTS

A total of 788 family physicians.

MAIN OUTCOME MEASURES

A computer use scale measured the extent to which family physicians integrated computers into their practices, with higher scores indicating a greater integration of computer use in practice. Analyses included tests and tests comparing new and traditional models of primary care on measures of computer use and electronic health record (EHR) use, as well as descriptive statistics.

RESULTS

Nearly all (97.5%) physicians reported using a computer in their practices, with moderately high computer use scale scores (mean [SD] score of 5.97 [2.96] out of 9), and many (65.7%) reported using EHRs. Physicians with practices operating under new models of primary care reported incorporating computers into their practices to a greater extent (mean [SD] score of 6.55 [2.64]) than physicians operating under traditional models did (mean [SD] score of 5.33 [3.15]; = 5.84; < .001; Cohen = 0.42, 95% CI 0.808 to 1.627) and were more likely to report using EHRs (73.8% vs 56.7%; [Formula: see text]; < .001; odds ratio = 2.15). Overall, there was a statistically significant variability in computer use across provinces.

CONCLUSION

Most family physicians in Canada have incorporated computers into their practices for administrative and scholarly activities; however, EHRs have not been adopted consistently across the country. Physicians with practices operating under the new, more collaborative models of primary care use computers more comprehensively and are more likely to use EHRs than those in practices operating under traditional models of primary care.

摘要

目的

研究计算机在基层医疗实践中的使用情况。

设计

2013年和2014年在加拿大开展了国际基层医疗质量与成本研究,采用描述性横断面调查方法从加拿大各地的医疗机构收集数据。参与调查的医疗机构填写了多项调查问卷,其中一项是家庭医生调查问卷,本研究从中收集数据。

地点

加拿大所有10个省份。

参与者

共有788名家庭医生。

主要观察指标

计算机使用量表衡量家庭医生将计算机融入其医疗实践的程度,得分越高表明计算机在实践中的融入程度越高。分析包括比较基层医疗新模式和传统模式在计算机使用和电子健康记录(EHR)使用方面的测试,以及描述性统计。

结果

几乎所有(97.5%)医生报告在其医疗实践中使用计算机,计算机使用量表得分中等偏高(9分制下平均[标准差]得分为5.97[2.96]),许多(65.7%)医生报告使用电子健康记录。采用基层医疗新模式的医生报告将计算机融入其医疗实践的程度(平均[标准差]得分为6.55[2.64])高于采用传统模式的医生(平均[标准差]得分为5.33[3.15];t = 5.84;P <.001;科恩d = 0.42,95%置信区间0.808至1.627),且更有可能报告使用电子健康记录(73.8%对56.7%;[公式:见正文];P <.001;优势比 = 2.15)。总体而言,各省之间计算机使用情况存在统计学上的显著差异。

结论

加拿大大多数家庭医生已将计算机用于行政和学术活动;然而,电子健康记录在全国并未得到一致采用。采用新型、更具协作性的基层医疗模式的医生比采用传统基层医疗模式的医生更全面地使用计算机,且更有可能使用电子健康记录。

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