Primary Care and Health Systems, ICES, 2075 Bayview Ave, G Wing, Toronto, M4N 3M5, Canada.
Department of Family and Community Medicine, University of Toronto, Toronto, Canada.
BMC Fam Pract. 2021 Nov 22;22(1):235. doi: 10.1186/s12875-021-01582-x.
Canadians are known to be frequent users of emergency department (ED) care. However, the exchange of information from ED visits to family physicians (FPs) is not well known. Our objectives were to determine whether Canadian FPs received information about their patient's ED visit and the patient characteristics related to the receipt of ED information.
This study was a descriptive record linkage study of FP Electronic Medical Record (EMR) data linked to health administrative data. Our study cohort included patients who had at least one ED visit in 2010 or 2015 in Ontario, Canada. An ED visit could include a transfer to or from another ED. The receipt of information from an ED note was examined in relation to patient age, sex, neighbourhood income quintiles, rurality and comorbidity.
There were 26,609 patients in 2010 and 50,541 patients in 2015 with at least one ED visit. In 2010, 53.3% of FPs received an ED note for patients having a single ED visit compared to 41.0% in 2015. For patients with multiple ED visits, 58.2% of FPs received an ED note in 2010 compared to 45.7% in 2015. FPs were more likely to receive an ED note for patients not living in low income neighbourhoods, older patients, patients living in small urban areas and for patients having moderate comorbidity. FPs were less likely to receive a note for patients living in rural areas.
Community-based FPs are more likely to get information after an ED visit for their older and sicker patients. However, FPs do not receive any information from EDs for over half their patients. Electronic health record technologies and their adoption by ED providers need to improve the seamless transfer of information about the care provided in EDs to FPs in the community.
加拿大人是急诊部(ED)护理的高频使用者。然而,ED 就诊信息向家庭医生(FP)的传递情况并不为人所知。我们的目的是确定加拿大的 FP 是否收到了有关其患者 ED 就诊的信息,以及与 ED 信息接收相关的患者特征。
这是一项描述性的 FP 电子病历(EMR)数据与健康管理数据的记录链接研究。我们的研究队列包括 2010 年或 2015 年在加拿大安大略省至少有一次 ED 就诊的患者。ED 就诊可包括从另一个 ED 转来或转至另一个 ED。检查了从 ED 记录中收到信息的情况与患者年龄、性别、社区收入五分位数、农村地区和合并症之间的关系。
2010 年有 26609 名患者,2015 年有 50541 名患者至少有一次 ED 就诊。2010 年,53.3%的 FP 收到了单一 ED 就诊患者的 ED 记录,而 2015 年这一比例为 41.0%。对于有多次 ED 就诊的患者,2010 年有 58.2%的 FP 收到了 ED 记录,而 2015 年这一比例为 45.7%。FP 更有可能收到来自非低收入社区的患者、年龄较大的患者、居住在小城区的患者和患有中度合并症的患者的 ED 记录。FP 不太可能收到来自农村地区患者的记录。
社区为基础的 FP 更有可能在 ED 就诊后获得其老年和病情较重的患者的信息。然而,超过一半的患者,FP 没有从 ED 获得任何信息。电子健康记录技术及其在 ED 提供者中的采用需要改进关于在 ED 提供的护理信息向社区 FP 的无缝传递。