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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,P<0.01)、2年(χ2=15.80,P<0.01)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,P<0.01)、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。
Objective To understand the activation of electronic health records of residents in a community and provide the basis for the rational allocation of community health resources. Methods Based on the community health service information system in Shenzhen City, a systematic sampling method was used to investigate the activation of electronic health records of residents in a community. Results A total of 4 353 health records were collected, of which 1.04 were male and female cases: 68.18% of them were aged from 21 to 50 years old. The 1, 2 and 5 years activation rates of the residents’ health records were 30.27% (1 318/4 353), 64.78% (2 820/4 353) and 95.52% (4 158/4 353). There was significant difference in the distribution of activation among different household registration files in one year (χ2 = 54.10, P <0.01) and 2 years (χ2 = 15.80, P <0.01) There was no significant difference in the distribution of activation between the two groups (P> 0.05). The trend test showed that there was statistically significant difference in the distribution of health records among residents at different ages (Z = -3.80, P <0.01) However, there was no significant difference in 5-year activation rate (Z = 0.06, P = 0.57). The health services that activate residents’ health archives in one year include clinical diagnosis and treatment, vaccination, periodic physical examination, health promotion and chronic disease management, accounting for 85.13%, 17.43%, 9.61% and 12.11% respectively of the total number of activated files, , 4.17%. Conclusion The activation rate of electronic health records of community residents is low, so it is necessary to expand the scope of community health services, allocate health resources reasonably and effectively improve community health service quality.