Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
Finnish Institute for Health and Welfare, Helsinki, Finland.
Prim Health Care Res Dev. 2022 Feb 3;23:e6. doi: 10.1017/S1463423622000019.
The aim of this study was to assess the feasibility of the national electronic primary health care (PHC) database in Kyrgyzstan in producing information on the disease burden of the patient population and on the processes and quality of care of noncommunicable diseases (NCDs) in PHC.
Strengthening of the PHC is essential for low- and middle-income countries (LMICs) to tackle the increasing burden of NCDs. Capacity building and quality improvement require timely data on processes and quality of care.
A data extraction was carried out covering four PHC clinics in Bishkek in 2019 to pilot the use of the national data for quality assessment purposes. The data included patient-level information on all appointments in the clinics during the year 2018 and consisted of data of altogether 48 564 patients. Evaluation indicators of the WHO Package of Essential NCD Interventions framework were used to assess the process and outcome indicators of patients with hypertension or diabetes.
The extracted data enabled the identification of different patient populations and analyses of various process and outcome indicators. The legibility of data was good and the structured database enabled easy data extraction and variable formation on patient level. As an example of process and outcome indicators of those with hypertension, the blood pressure was measured at least on two occasions of 90% of women and 89% of men, and blood pressure control was achieved among 61% of women and 53% of men with hypertension. This study showed that a rather basic system gathering nationally patient-level data to an electronic database can serve as an excellent information source for national authorities. Investments should be made to develop electronic health records and national databases also in LMICs.
本研究旨在评估吉尔吉斯斯坦国家电子初级卫生保健(PHC)数据库在生成患者人群疾病负担信息以及 PHC 中非传染性疾病(NCD)的流程和质量信息方面的可行性。
加强 PHC 对于中低收入国家(LMIC)应对不断增加的 NCD 负担至关重要。能力建设和质量改进需要及时了解流程和护理质量的数据。
2019 年,在比什凯克的四个 PHC 诊所进行了数据提取,以试点使用国家数据进行质量评估。数据包括 2018 年诊所所有预约的患者级信息,共有 48564 名患者的数据。使用世界卫生组织基本 NCD 干预包框架的评估指标来评估高血压或糖尿病患者的流程和结果指标。
提取的数据能够识别不同的患者人群,并分析各种流程和结果指标。数据的可读性良好,结构化数据库能够方便地在患者层面进行数据提取和变量形成。作为高血压患者流程和结果指标的一个例子,女性中有 90%、男性中有 89%至少在两次就诊时测量了血压,高血压女性中有 61%、男性中有 53%血压得到了控制。本研究表明,一个相当基础的系统,可以将全国范围内的患者层面数据汇集到一个电子数据库中,可以作为国家当局的优秀信息来源。在中低收入国家,也应投资开发电子健康记录和国家数据库。