Phanthunane Pudtan, Wattanasaovaluk Kritsada, Suwatmakin Atipan, Suksak Anon, Tangchaisuriya Udomsak, Tonmukayakul Utsana, Ratchadaporn Nopparat, Kowatcharakul Woravut, Patmasiriwat Direk
Faculty of Business, Economics and Communications, Naresuan University, Phitsanulok, Thailand.
Centre for Health Equity Monitoring Foundation, Phitsanulok, Thailand.
Healthc Inform Res. 2025 Jul;31(3):235-244. doi: 10.4258/hir.2025.31.3.235. Epub 2025 Jul 31.
Thailand recently implemented an electronic emergency referral system, known as "HIS.SANSAI," to improve the speed, efficiency, and quality of patient care. This study evaluated the impact of HIS.SANSAI on user experiences and health outcomes.
A multimethod approach was employed, combining data analysis from a cross-sectional survey that quantified users' preferences and perceptions with an examination of de-identified emergency referral records from 2019 to 2021. Multiple regression analysis assessed whether HIS.SANSAI significantly reduced the duration of medical services, while logistic regression evaluated changes in health outcomes before and after its implementation.
The survey results revealed high proficiency in system capabilities. Referring hospitals (sending hospitals) rated the system highest, with a score of 8.00 for "Reducing coordinated time." Referral hospitals (receiving hospitals) expressed moderate satisfaction, scoring highest (7.03) for "Reducing mistakes in patient information transfer" and lowest (4.27) for "Ease of use when recording." The effects of HIS.SANSAI were partially supported. Positive outcomes included shorter service times and a 13.16% reduction in severity at emergency room discharge for ischemic stroke patients. However, negative consequences were observed, such as notable treatment delays for acute appendicitis patients.
HIS.SANSAI demonstrated robust system capabilities and reduced errors in patient information transfer. Its impact on health outcomes was mixed, with both positive and negative effects. Further evaluation and enhancements are necessary to optimize the system's overall effectiveness.
泰国最近实施了一个名为“HIS.SANSAI”的电子紧急转诊系统，以提高患者护理的速度、效率和质量。本研究评估了HIS.SANSAI对用户体验和健康结果的影响。
采用多方法 approach，将横断面调查的数据分析（该调查量化了用户的偏好和看法）与对2019年至2021年匿名紧急转诊记录的检查相结合。多元回归分析评估HIS.SANSAI是否显著缩短了医疗服务时长，而逻辑回归评估其实施前后健康结果的变化。
调查结果显示系统功能熟练度较高。转诊医院（发送医院）对该系统评价最高，“减少协调时间”一项得分为8.00。接收转诊的医院（接收医院）表示满意度中等，“减少患者信息传递错误”得分最高（7.03），“记录时的易用性”得分最低（4.27）。HIS.SANSAI的效果得到了部分支持。积极成果包括服务时间缩短，缺血性中风患者急诊室出院时的严重程度降低了13.16%。然而，也观察到了负面后果，如急性阑尾炎患者出现明显的治疗延迟。
HIS.SANSAI展示了强大的系统功能，并减少了患者信息传递中的错误。其对健康结果的影响喜忧参半，有积极和消极两方面的影响。需要进一步评估和改进，以优化该系统的整体有效性。
