我国居民电子健康档案建设现状调查

摘要

目的：描述流动人口卫生和计划生育基本公共服务试点城市居民电子健康档案建设现状，梳理建档中存在问题，为电子健康档案进一步建设与管理提供依据。方法：调查40个试点城市人口、经济及电子健康档案建设状况等。结果：地区生产总值是电子健康档案建设数量可能的影响因素（r=0.867，P<0.01；集中指数C=0.0266），公共卫生服务经费投入水平可能影响电子健康档案建档率（r=0.440，P<0.01），试点城市电子健康档案覆盖情况均衡性较好（基尼系数G=0.0828），直辖市下辖区与其余城市建档模式、建档类型无显著差异（χ2=5.81，P=0.07；χ2=3.43，P=0.22），但户籍与流动人口的建档率存在显著差异（Z=-2.90，P<0.01）。结论：试点城市电子健康档案建设现已取得较好成果；经济水平可能影响档案建设；对流动人口的建档工作和档案利用仍有不足。%Objective:To describe current progress on electronic health records(EHRs) construction among pilot cities where basic public health services for migrant population in China were put into practice;and provide a reference to further better construction,management and application of EHRs.Methods:The structure questionnaire was applied to collect demographic,economic characteristics as well as construction of EHRs in 40 pilot cities.Results:Regional gross domestic product(GDP) was one of the potential factors associated with total numbers of EHRs(r=0.867,P<0.01,concentrated index=0.026 6). The construction rate might be influenced by financial investment to public health services(r=0.440,P<0.01). EHRs construction rate distributed equitably among pilot cities (Gini=0.082 8). As for health record construction pattern(primary,middle and advanced) and construction type(paper-based,electronic and both),there was no significant difference between districts under the jurisdiction of municipalities and other cities(χ2=5.81,P=0.07 andχ2=3.43,P=0.22,respectively). Significant difference of EHRs construction rate was observed between local residence and migrant population(Z=-2.90,P<0.01).Conclusion:Some achievement of EHRs construction was observed among pilot cities. Progress on EHRs construction could be influenced by economic factors. There is still insufficiency in EHRs construction and application for migrant population.