Lehtovuori Tuomo, Raina Marko, Suominen Lasse, Kauppila Timo
, Siltakatu 11, 3. krs, 02770, Espoo, Finland.
, Peltolantie 2, 01300, Vantaa, Finland.
BMC Res Notes. 2017 Dec 6;10(1):700. doi: 10.1186/s13104-017-3054-2.
To improve the recording of diagnoses in visits to general practitioners, an observational retrospective study based on a before-after design was performed by installing an electronic reminder in the computerized patient chart system, reinforced in feedback delivered in superior-subordinate or development discussions with the general practitioners. The monthly rate of recording diagnoses was observed before and after the intervention. The effect of this intervention on recording of diagnoses was compared with the effects of financial group bonuses on the same parameter in a neighbouring city.
Before intervention, the level of recording diagnoses was about 45% in the primary care units. Nine months after this intervention there was not yet any statistically significant increase in recording of diagnoses but after 21 months it yielded a recording rate of 90% (P < 0.001). In three years, this percentage reached level over 95%. Group bonuses, a financial incentive serving as a control intervention, increased this parameter from 50 to 80% (P < 0.001) in nine months, and in 21 months the level of recording diagnoses was 90%. The both methods increased the level of recording diagnoses at the same level. Group bonuses acted faster but were also more expensive.
为提高全科医生诊疗记录中的诊断信息，开展了一项基于前后对照设计的观察性回顾性研究，通过在计算机化病历系统中安装电子提醒功能，并在与全科医生的上下级沟通或业务发展讨论中强化反馈来实现。观察干预前后每月的诊断记录率，并将该干预措施对诊断记录的影响与邻近城市财务小组奖金对同一参数的影响进行比较。
干预前，基层医疗单位的诊断记录水平约为45%。干预九个月后，诊断记录率尚未出现统计学上的显著提高，但21个月后记录率达到了90%（P<0.001）。三年后，这一百分比达到95%以上。作为对照干预措施的小组奖金在九个月内将该参数从50%提高到80%（P<0.001），21个月后诊断记录水平为90%。两种方法提高诊断记录水平的程度相同。小组奖金起效更快，但成本也更高。
