社区电子健康档案使用情况及影响因素研究  

The Utilization and Influencing Factors of Community Electronic Health Records

作　　者：何梅亮 刘修良 赵梅桂[1] 郭艳芳[1] 徐英[1] HE Meiliang;LIU Xiuliang;ZHAO Meigui;GUO Yanfang;XU Ying(Shenzhen Baoan District Chronic Disease Prevention and Control Hospital,Shenzhen 518101,China)

机构地区：[1]广东省深圳市宝安区慢性病防治院,518101

出　　处：《中国全科医学》2025年第13期1628-1634,共7页Chinese General Practice

基　　金：宝安区医疗卫生基础研究项目(2020JD096);宝安区医学重点学科(慢性非传染性疾病防控)。

摘　　要：背景居民电子健康档案工作自推行以来已取得阶段性成效,广东省深圳市的建档率目标已实现,使用率成为该项工作优化管理的核心指标。目的了解深圳市宝安区居民电子健康档案使用情况,并分析影响因素,为提高健康档案使用率、优化社区卫生资源配置提供依据。方法截至2022-12-31,深圳市社区健康服务信息系统中共有宝安区居民电子健康档案4077665份,采用系统抽样法抽取403700份,筛选出符合研究要求的401853份进行分析。摘录居民健康档案门诊记录、随访记录及体检记录信息,计算居民电子健康档案的1、2、3年使用率,采用多因素Logistic回归分析使用情况的影响因素。结果居民健康档案的1、2、3年使用率分别为59.30%(238131/401853)、74.90%(301032/401853)、80.10%(321853/401853)。多因素Logistic回归分析结果显示,年龄、民族、常住类型、婚姻状况、文化程度、职业、医疗费用支付方式、建档时长,以及档案是否有家庭医生签约标识、老年人专案标识、高血压专案标识、糖尿病专案标识是居民电子健康档案1、2、3年使用情况的影响因素(P<0.05)。其中,与21~45岁居民相比,0~1、2~3、4~6岁居民的1、2、3年使用率较高(OR>1.00,P<0.05),46~60、≥61岁居民的1、2、3年使用率较低(OR<1.00,P<0.05);与常住非深圳市户籍居民相比,常住深圳市户籍居民的1、2、3年使用率较高(OR>1.00,P<0.05);与城镇职工基本医疗保险参保居民相比,城镇居民基本医疗保险、全自费及其他医疗费用支付方式居民的1、2、3年使用率较低(OR<1.00,P<0.05);与建档<1年的居民相比,建档≥1年居民的1、2、3年使用率较低(OR<1.00,P<0.05);与无相应专案标识的居民相比,有家庭医生签约标识、老年人专案标识、高血压专案标识、糖尿病专案标识的1年使用率较高[OR(95%CI)分别为3.77(3.70~3.84)、2.73(2.53~2.94)、4.40(4.11~4.72)、3.10(2.78~3.47),P<0.05],2年和Background Since its implementation,residents'electronic health records have achieved phased results.The target of the filing rate in Shenzhen,Guangdong Province has been achieved,and the utilization rate has become the core index of theoptimization management of this work.Objective To understand the use of electronic health records of residents in Bao'an District,Shenzhen,and to analyze the influencing factors.It provides a basis for improving the utilization rate of health records and optimizing the allocation of community health resources.Methods As of 2022-12-31,Shenzhen Community Health Service information system had a total of 4077665 electronic health records of Bao'an District residents.403700 electronic health records were selected by systematic sampling method,and 401853 meeting the requirements of the study were selected for analysis.Results The utilization rates of health records in 1 year,2 years and 3 years were 59.30%(238131/401853),74.90%(301032/401853)and 80.10%(321853/401853).The results of multivariate Logistic regression analysis showed that age,nationality,resident type,marital status,education level,profession,payment methods for medical expenses,duration of filing,as well as whether the health records were signed by a family doctor,the elderly,the hypertension and the diabetes were residents'electronic health records influencing factors of 1,2 and 3 years use(P<0.05).Among them,compared with residents aged 21-45,the use rate of electronic health records in 1,2 and 3 years was higher for residents aged 0-1,2-3 and 4-6 years(OR>1.00,P<0.05);the usage rate of electronic health records for residents aged 46-60 and≥61 years was lower in 1,2 and 3 years(OR<1.00,P<0.05);compared with non-resident residents of Shenzhen,the use rate of electronic health records of residents with permanent residence in Shenzhen was higher at 1,2 and 3 years(OR>1.00,P<0.05);compared with the residents participating in the basic medical insurance for urban employees,the use rate of electronic health records of reside

关 键 词：电子健康档案 卫生服务使用研究 社区卫生服务 家庭医生签约服务 影响因素分析 

分 类 号：R197.3[医药卫生—卫生事业管理]