HEALTH CARE REFORM Patients Treated at Multiple Acute Health Care Facilities Quantifying Information Fragmentation
HEALTH CARE REFORM Patients Treated at Multiple Acute Health Care Facilities Quantifying Information Fragmentation
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DOI：
10.1001/archinternmed.2010.439
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发表时间：
2010-12-13
影响因子：
--
通讯作者：
Mandl, Kenneth D.
中科院分区：
文献类型：
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作者：
Bourgeois, Fabienne C.;Olson, Karen L.;Mandl, Kenneth D.
工作背景：医疗信息的碎片化使患者面临医疗错误、不良事件、重复测试和成本增加的风险。我们试图通过测量个人在多个地点寻求护理的比率，在人口水平上量化马萨诸塞州急性护理环境中碎片化的负担。方法：一项回顾性观察性研究，研究对象为自2002年10月1日起在马萨诸塞州急诊科、住院部和观察部至少就诊或住院2次的所有成人患者，结果：在本研究期间，共有3 692 178例成人患者到急诊医疗机构就诊，其中12 758 498例患者到急诊医疗机构就诊。在研究期间，共有1130124名成人患者（31%）访问了2家或更多医院，占所有急性护理访视的56.5%，而43794名患者（1%）访问了5家或更多医院，占所有急性访视的近十分之一。多次就诊的患者年龄较轻（P
Background: Fragmentation of medical information places patients at risk for medical errors, adverse events, duplication of tests, and increased costs. We sought to quantify, at the population level, the burden of fragmentation in the acute care setting across the state of Massachusetts by measuring the rates at which individuals seek care across multiple sites.Methods: A retrospective observational study of all adult patients with at least 2 visits or hospitalizations to the emergency departments, inpatient units, and observation units in Massachusetts from October 1, 2002, to September 30, 2007.Results: The 3 692 178 adult patients who visited an acute care site during our study period accounted for 12 758 498 acute care visits. A total of 1 130 124 adult patients (31%) visited 2 or more hospitals during the study period, ac-counting for 56.5% of all acute care visits, while a subgroup of 43 794 patients (1%) visited 5 or more hospitals, contributing to almost one-tenth of all acute visits. Patients who visited multiple sites were younger (P