Liaw S T, Radford A J, Maddocks I
Department of Public Health and Community Medicine, University of Melbourne.
Aust Fam Physician. 1998 Jan;27 Suppl 1:S39-43.
To examine the use and impact of a computer generated, patient held health record (PHR) on information sharing, responsibility sharing and preventive health care.
An academic group, private solo and private group general practice in Adelaide, South Australia.
Patients with chronic health problem(s) were randomly assigned to an experimental control or post test only group. Pre and post intervention data were collected using a standardised audit and abstraction of the patient records into a computer based record system. In addition, patient and doctor questionnaires, telephone follow ups and face to face interviews were conducted.
Patient and GP use of, and satisfaction with the PHR; effectiveness of information and responsibility sharing; and uptake and performance of selected preventive health care by patient and GP.
Seventy-two patients were recruited (29 received the PHR, and 22 each were in the control and post test only groups). The PHR was well received and used in both primary and secondary care settings. No statistically significant differences in the outcome measures were found between the groups as well as before and after the intervention (Kruskal-Wallis, p > 0.05). Data trends suggested that the PHR may increase information and responsibility sharing as well as improve patient awareness of the issues involved, with patient participation in information sharing, preventive health care and clinical decision making. Provided training and resources were made available, participating GPs believed that the computer based methodology developed was a practical option for use in practice.
The computer generated PHR is an important determinant of patient participation in information and responsibility sharing, health promotion, and disease management. Implementation and evaluation studies are recommended.
研究计算机生成的患者持有的健康记录(PHR)在信息共享、责任分担和预防保健方面的使用情况及影响。
南澳大利亚阿德莱德的一个学术团体、私人单干及私人团体全科医疗实践。
患有慢性健康问题的患者被随机分配到实验对照组或仅接受后测的组。干预前后的数据通过标准化审核收集,并将患者记录摘要到基于计算机的记录系统中。此外,还进行了患者和医生问卷调查、电话随访及面对面访谈。
患者和全科医生对PHR的使用情况及满意度;信息和责任共享的有效性;患者和全科医生对选定预防保健措施的采用情况及执行情况。
招募了72名患者(29名接受了PHR,对照组和仅接受后测的组各有22名)。PHR在初级和二级保健环境中均受到好评并得到使用。在各研究组之间以及干预前后,结果指标均未发现统计学上的显著差异(Kruskal-Wallis检验,p>0.05)。数据趋势表明,PHR可能会增加信息和责任共享,提高患者对相关问题的认识,促进患者参与信息共享、预防保健和临床决策。如果提供培训和资源,参与的全科医生认为所开发的基于计算机的方法在实践中是一种可行的选择。
计算机生成的PHR是患者参与信息和责任共享、健康促进及疾病管理的重要决定因素。建议开展实施和评估研究。