急诊外科患者数量对电子病历使用的影响  

The effect of the number of emergency surgical patients on the use of electronic medical records

作　　者：张志远[1] 杨敏[1] 宋小兵[1] 

机构地区：[1]武汉大学中南医院急诊外科,武汉430071

出　　处：《临床急诊杂志》2016年第12期957-959,共3页Journal of Clinical Emergency

摘　　要：目的:探讨急诊外科患者数量的多少是否影响电子病历的使用。方法:以2014-11-2015-04在我院急诊外科就诊的患者为A组,2015-05-2015-10就诊的患者为B组,2组时间内接诊医师无人事、人员数量变动,均为8名医师;对每位接诊医师在A组及B组所接诊患者的数量,电子病历使用率,患者等待医生看诊总时间和收入院患者的总体等待入院时间进行对比分析。结果:A组内单个医师接诊患者量为(2 256±124)例,B组为(3 036±195)例,2组差异有统计意义(t=7.82,P<0.05)。A组电子病历完成率为(94.5±2.3)%,B组电子病历完成率为(94.0±1.3)%,2组差异无统计学意义。A组患者等待就诊时间为(12.2±2.1)min,B组为(13.2±1.7)min,2组差异无统计学意义。A组收住院患者住院时间为(77.2±8.8)min,B组为(72.8±5.9)min,2组差异无统计学意义。结论:急诊外科患者的数量并不影响结构化电子病历的使用,也不影响患者的等待时间和入院时间,应大力推行电子病历的使用。Objective：To investigate whether the number of emergency surgical patients affected the use of electronic medical records.Method：The patients who got treated by emergency surgery department in Zhongnan Hospital of Wuhan University from November 2014 to April 2015 were set as group A,and the patients got treated from May 2015 to October 2015 were set as group B.In the two different periods,there were 8clinicians and there were no personnel changes.The number of patients who were supported by each single cliniclan admitted in group A and group B,the rate of using electronic medical records,the total waiting time of patients waiting for doctors and the waiting time of hospitalization of patients admitted to hospitals were compared and analyzed.Result：The number of patients who were supported by each single cliniclan admitted in group A was（2 256±124）and the group B（3 036±195）,there were statistically significant differences between the two groups（t=7.82,P〈0.05）.The completion rate of electronic medical records in group A was（94.5±2.3）%,（94.0±1.3）%in group B,respectively,there was no statistically significant difference.The total waiting time of patients waiting for doctors in group A was（12.2±2.1）min,and that in group B was（13.2±1.7）min,there was no significant difference.The waiting time of hospitalization in group A was（77.2±8.8）min in group A and（72.8±5.9）min in group B,the difference was not statistically significant.Conclusion：The number of emergency surgical patients does not affect the use of structured electronic medical records,nor affect the patient＇s waiting time and admission time.The use of electronic medical records is worth promoting.

关 键 词：急诊外科 患者数 电子病历 

分 类 号：R197.32[医药卫生—卫生事业管理]