Weir Rosy Chang, Toyoji Mariko, McKee Michael, Li Vivian, Wang Chia C
J Health Care Poor Underserved. 2018;29(4):1587-1605. doi: 10.1353/hpu.2018.0114.
Hepatitis B virus (HBV) infection is a major health disparity between Asian Americans, Native Hawaiians, and Pacific Islanders compared with other racial/ethnic groups in the U.S.
Our aims were to determine the effectiveness of an electronic health record (EHR) data-driven clinical intervention to improve HBV screening and vaccination rates at a community health center primarily serving Asian American patients.
Using a community-engaged approach, we conducted a study to compare the differences in screening and vaccination rates for 6,429 patient encounters before and after implementation of the EHR intervention. A multivariable logistic regression analysis was conducted to estimate the effect of the intervention.
Analyses indicated that patients who visited the clinic after implementing the EHR intervention were more likely to be screened (OR=1.8, p<.001) and vaccinated (OR=2.8, p<.001) for hepatitis B.
Electronic health record interventions implemented using a community-engaged approach may improve delivery of appropriate care to patients at risk for hepatitis B in a community health setting.
与美国其他种族/族裔群体相比，乙型肝炎病毒（HBV）感染是亚裔美国人、夏威夷原住民和太平洋岛民之间的一个主要健康差异问题。
我们的目的是确定一种以电子健康记录（EHR）数据为驱动的临床干预措施在主要服务亚裔美国患者的社区健康中心提高HBV筛查和疫苗接种率方面的有效性。
采用社区参与方法，我们开展了一项研究，比较实施EHR干预前后6429次患者就诊的筛查和疫苗接种率差异。进行多变量逻辑回归分析以估计干预效果。
分析表明，实施EHR干预后到诊所就诊的患者更有可能接受HBV筛查（比值比=1.8，p<0.001）和接种疫苗（比值比=2.8，p<0.001）。
采用社区参与方法实施的电子健康记录干预措施可能会改善社区健康环境中对乙型肝炎高危患者的适当护理服务。
