深圳市光明新区某社区居民电子健康档案活化率分析

目的了解某社区居民电子健康档案活化情况,为社区卫生资源的合理配置提供依据。方法以深圳市社区卫生服务信息系统为基础,采用系统抽样的方法对某社区居民的电子健康档案活化情况进行调查。结果抽取了4 353份健康档案,其中男女病例为1.04:1,21~50岁年龄段占68.18%,所抽查的居民健康档案中1年、2年、5年活化率分别为30.27%(1 318/4 353)、64.78%(2 820/4 353)和95.52%(4 158/4 353)。不同户籍档案,其1年(χ2=54.10,P0.01)、2年(χ2=15.80,P0.01)活化情况分布差异有统计学意义,而在5年(χ2=0.01,P=0.98)活化情况分布差异无统计学意义;趋势检验,不同年龄段居民健康档案1年(Z=-3.80,P0.01)、2年(Z=-2.56,P=0.01)活化率分布差异有统计学意义,但5年活化率分布差异无统计学意义(Z=0.06,P=0.57)。1年内对居民健康档案进行活化的卫生服务主要有:临床诊疗、预防接种、个人周期性体检、健康促进、慢病管理,其分别占活化档案总数的85.13%、17.43%、9.61%、12.11%、4.17%。结论社区居民电子健康档案活化率较低,需要扩展社区卫生服务范围,进行卫生资源合理配置,有效提高社区卫生服务质量。

Analysis on the activation rates of electronic health records among residents of a community in Guangming District,Shenzhen

Objective To investigate the activation rate of electronic health records among residents of a community, and to provide evidence for rationally allocating community health resources. Methods Based on the community health service infor- mation system, systematic sampling method was applied to investigate the activation rate of electronic health records among resi- dents of a community in Shenzhen City. Results Totally 4,353 electronic health records were surveyed, with the sex ratio of male to female 1.04 ： 1. 68.18 % of the cases were residents aged 21 - 50 years. The one - , two - and five - year activation rates were 30.27% （1,318/4,353）, 64.78% （2,820/4,353） and 95.52% （4,158/4,353）. Among the subgroups of census registers, there were statistically significant differences between one - year activation rate （ X2 = 54.10, P 〈 0.01 ） and two - year activation rate （ Xa = 15.80, P 〈 0.01）, while no statistically significant difference was found in five - year activation rate （ 2 = 0.01, P = 0.98）. Tendency analysis showed that the distributions of one - year activation rate （ Z = - 3.80, P 〈 0.01 ） and two- year activation rate （Z = -2.56, P = 0.01 ） in different age range subgroups were statistically significant different, while that of five - year activation rate was not （ Z = 0.06, P = 0.57）. The health services with activated health records within one year included the clinical diagnosis and treatment, vaccination, personal periodic physical examination, health promotion and chronic disease management, with the ratios of 85.13%, 17.43%, 9.61%, 12.11% and 4.17% in the total active health records, respectively. Conclusions The activation rate of electronic health records of the residents in the community in Guangming District, Shenzhen City is lower. It is necessary to expand community health services and allocate health resources rationally so as to effectively improve the quality of community health services.