电子病历对医院精神科病案管理价值分析  

Analysis of the Value of Electronic Medical Records in the Management of Psychiatric Medical Records

作　　者：谢忠[1] 王珍 吴猜 Xie Zhong;Wang Zhen;Wu Cai(Department of Psychiatry,Ziyang Psychiatric Hospital,Zivang 641300,Sichuan Province,China;不详)

机构地区：[1]资阳市精神病医院精神科,四川省资阳市641300

出　　处：《中国病案》2022年第6期6-9,共4页Chinese Medical Record

摘　　要：目的 分析电子病历对医院精神科病案管理价值,以期指导和提升病案科管理质量。方法 随机选取精神科2019年1月1日至2020年12月1日病案117份,将其纳入研究组。另随机选择医院2017年1月1日至2018年12月1日诊治的精神科病案117份,将其纳入对照组。对照组使用纸质病案管理,研究组使用电子病历管理。比较两组病案管理满意度、病案回收率/及时性、病案内容合格情况、病案复印情况。结果 研究组病案管理总满意率96.58%高于对照组(P<0.05)。研究组病案回收率/及时l率88.03%、病案内容合格率95.73%高于对照组(P<0.05)。研究组申请病案复印次数(4.09±0.19)次对于对照组(P<0.05),申请至收到病案时间(1.71±0.49)天、申请查看病案等待时间(1.41±0.16)天少于对照组(P<0.05)。结论 电子病历管理能提升精神科病案管理满意度,减少申请查看病案等待时间,增加复印次数。Objectives To analyze the value of electronic medical record management in psychiatric department of hospital,in order to guide and improve the management quality of medical record department.Methods A total of 117 psychiatric records were randomly selected from the psychiatric department of the hospital from January 1 st,2019 to December 1 st,2020 and included in the study group.Another 117 psychiatric cases were randomly selected from January 1 st,2017 to December 1 st,2018,and included in the control group.The control group used paper medical record management,and the study group used electronic medical record management.The satisfaction degree of medical record management,recovery rate/timeliness of medical record,qualified medical record content and medical record copying were compared between the two groups.Results The total satisfaction rate of medical record management in study group was 96.58% higher than that in control group(P<0.05).The recovery rate of medical records and the qualified rate of medical records in the study group were 88.03% and 95.73%,respectively,higher than those in the control group(P<0.05).For the control group(P<0.05),the application time to receive the medical record(1.71±0.49) d and the application time to view the medical record(1.41±0.16) d were less than the control group(P<0.05).Conclusions Electronic medical record management could improve the satisfaction of psychiatric medical record management,reduce the waiting time for application to view medical records,and increase the number of copies.

关 键 词：电子病历 医院 精神科 病案 管理 价值 

分 类 号：R197.323[医药卫生—卫生事业管理]