Procurement of patient medical records from multiple health care facilities for public health research: feasibility, challenges, and lessons learned.

IF 2.5 Q2 HEALTH CARE SCIENCES & SERVICES JAMIA Open Pub Date : 2023-07-01 DOI:10.1093/jamiaopen/ooad040
James M McMahon, Judith Brasch, Eric Podsiadly, Leilani Torres, Robert Quiles, Evette Ramos, Hugh F Crean, Jessica E Haberer
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Abstract

Objectives: Studies that combine medical record and primary data are typically conducted in a small number of health care facilities (HCFs) covering a limited catchment area; however, depending on the study objectives, validity may be improved by recruiting a more expansive sample of patients receiving care across multiple HCFs. We evaluate the feasibility of a novel protocol to obtain patient medical records from multiple HCFs using a broad representative sampling frame.

Materials and methods: In a prospective cohort study on HIV pre-exposure prophylaxis utilization, primary data were collected from a representative sample of community-dwelling participants; voluntary authorization was obtained to access participants' medical records from the HCF at which they were receiving care. Medical record procurement procedures were documented for later analysis.

Results: The cohort consisted of 460 participants receiving care from 122 HCFs; 81 participants were lost to follow-up resulting in 379 requests for medical records submitted to HCFs, and a total of 343 medical records were obtained (91% response rate). Less than 20% of the medical records received were in electronic form. On average, the cost of medical record acquisition was $120 USD per medical record.

Conclusions: Obtaining medical record data on research participants receiving care across multiple HCFs was feasible, but time-consuming and resulted in appreciable missing data. Researchers combining primary data with medical record data should select a sampling and data collection approach that optimizes study validity while weighing the potential benefits (more representative sample; inclusion of HCF-level predictors) and drawbacks (cost, missing data) of obtaining medical records from multiple HCFs.

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从多个卫生保健机构采购患者医疗记录用于公共卫生研究:可行性、挑战和经验教训。
目标:结合医疗记录和原始数据的研究通常在覆盖有限集水区的少数卫生保健设施(HCFs)中进行;然而,根据研究目标的不同,可以通过在多个hcf中招募更广泛的接受治疗的患者样本来提高有效性。我们评估了一种新的方案的可行性,该方案使用广泛的代表性采样框架从多个hcf中获取患者医疗记录。材料和方法:在一项关于HIV暴露前预防利用的前瞻性队列研究中,从社区居住参与者的代表性样本中收集了主要数据;获得了自愿授权,可以从参与者接受治疗的HCF获取他们的医疗记录。病历采购程序被记录下来,供以后分析。结果:该队列包括460名接受122名hcf护理的参与者;81名参与者失去了随访,导致向hcf提交了379份医疗记录请求,总共获得了343份医疗记录(回复率为91%)。收到的医疗记录中只有不到20%是电子形式的。病历获取的平均成本为每份病历120美元。结论:获取在多个hcf中接受治疗的研究参与者的病历数据是可行的,但耗时且导致明显的数据缺失。将原始数据与病历数据相结合的研究人员应选择一种抽样和数据收集方法,以优化研究的有效性,同时权衡潜在的益处(更具代表性的样本;包括hcf水平预测因子)和从多个hcf获取医疗记录的缺点(成本、缺失数据)。
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来源期刊
JAMIA Open
JAMIA Open Medicine-Health Informatics
CiteScore
4.10
自引率
4.80%
发文量
102
审稿时长
16 weeks
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