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 4 077 665 electronic health records of Bao 'an District residents. 403 700 electronic health records were selected by systematic sampling method, and 401 853 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% (238 131/401 853), 74.90% (301 032/401 853) and 80.10% (321 853/401 853). 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 residents with basic medical insurance, full self-payment and other medical expenses payment methods for urban residents was lower in 1, 2 and 3 years (OR<1.00, P<0.05) ; compared with residents with a filing period of<1 year, the use rate of electronic health records of residents with a filing period of≥1 year was lower at 1, 2 and 3 years (OR<1.00, P<0.05) ; compared with the residents without the corresponding project identification, the 1-year utilization rate of electronic health records with family doctor contract identification, elderly project identification, hypertension project identification, and diabetes project identification was higher[OR (95%CI) was 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], respectively, and the 2-years and 3-years usage rates were also higher (OR>1.00, P<0.05) .
Conclusion The usage rate of electronic health records among residents in Bao'an District has risen compared to previous levels, but there is still potential for further enhancement. Priority should be given to non-elderly people, middle-aged and elderly people identified by the hypertension/diabetes program, and residents who have not signed a family doctor, basic medical insurance for urban residents, payment methods for self-payment and other medical expenses, and non-household registration residents.
