Department of Nephrology, Chang Gung Memorial Hospital, Linkou, Taiwan.
College of Medicine, Chang Gung University, Taoyuan City, Taiwan.
Sci Rep. 2017 Jun 7;7(1):2985. doi: 10.1038/s41598-017-02815-9.
Aggressively applying e-interventions in the health care industry has become a global trend to improve the quality of medical care. The present retrospective study evaluated the effect of electronic information systems on the quality of medical care provide to hemodialysis (HD) patients. In total, 600 patients (300 patients each in the e-intervention and non-e-intervention groups, were matched for sex, age, HD duration, diabetes, and hypertension) receiving HD at the study institute for four years were included in this study. The e-intervention group had significantly fewer hospitalization days than the non-e-intervention group. Cox regression analysis demonstrated that the non-e-intervention group had a significantly higher mortality rate than the e-intervention group. Stratified analysis revealed significant differences between the e-intervention and non-e-intervention groups in their serum albumin levels, urea reduction ratios, and cardiothoracic ratios at 1-year follow-up. The patients in the e-intervention group had a significantly higher HD blood flow rate, fewer hospitalization days and a lower 4-year all-cause mortality rate than those in the non-e-intervention group. The implementation of the e-intervention improved patient outcomes, but additional studies are required to evaluate the cost effectiveness of such implementations.
积极在医疗保健行业应用电子干预已成为提高医疗质量的全球趋势。本回顾性研究评估了电子信息系统对血液透析(HD)患者医疗质量的影响。在本研究中,共有 600 名患者(每组 300 名,电子干预组和非电子干预组在性别、年龄、HD 持续时间、糖尿病和高血压方面相匹配)在研究机构接受 HD 治疗四年。电子干预组的住院天数明显少于非电子干预组。Cox 回归分析表明,非电子干预组的死亡率明显高于电子干预组。分层分析显示,电子干预组和非电子干预组在 1 年随访时的血清白蛋白水平、尿素降低率和心胸比方面存在显著差异。电子干预组的 HD 血流速度明显较高,住院天数较少,4 年全因死亡率明显较低。电子干预的实施改善了患者的预后,但需要进一步研究来评估这种实施的成本效益。