Automated process assessment of primary healthcare for hyperlipidemia: preliminary findings and implications form Anhui, China.

IF 3.9 2区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Lipids in Health and Disease Pub Date : 2025-01-22 DOI:10.1186/s12944-025-02435-7

Ningjing Yang, Yuning Wang, Ying Li, Dongying Xiao, Ruirui Cui, Nana Li, Rong Liu, Jing Chai, Xingrong Shen, Debin Wang

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Abstract

Background: Primary healthcare (PHC) plays a key role in hyperlipidemia (HL) management yet lacks adequate monitoring and feedback. This study aims at identifying pragmatic measures out from routinely collected electronic records to enable automatic monitoring and inform continuous optimization of HL-management at PHC settings.

Methods: The study used randomly selected electronic records of PHC (from the province-wide data center of Anhui-province, China) as the main data source and generated both procedure-based and encounter-based measures for assessing HL-management. The procedure-based measures were derived from specific quality-facts of 21 stages/procedures (e.g., lipid lowering medication prescription) using self-designed algorithms. While the encounter-based measures included number or rate of visits for HL, currently-noticed hyperlipidemia (CNHL, or HL noticed during the current consultation), and ever-diagnosed hyperlipidemia (EDHL). Analysis of these measures employed mainly simple descriptives and linear regression modeling.

Results: The study revealed interesting findings including: low and varied rates of visits for HL(from 0.01 to 1.43%) and visits by patients with EDHL/CNHL(from 0.13 to 20.54% or from 0.02 to 2.99%) between regions; large differences (5.14 to 22.20 times) between the mean or cumulative proportions of visits by patients with EDHL versus CNHL among clinician groups; consistent increase in the ratio of visits for HL in all cause visits over the study period (from 0.087 to 1.000%) accompanied with relatively stable proportions of patients with CNHL/EDHL; Relatively low scores in the procedure-based measures (ranged from 0.00 to 36.08% for specific procedures by seasons).

Conclusions: The measures identified are not only feasible from real-world PHC records but also give some useful metrics about how well current HL-management is going and what future actions are needed.

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高脂血症初级保健的自动化过程评估：初步发现和启示来自安徽，中国。

背景：初级卫生保健（PHC）在高脂血症（HL）的管理中起着关键作用，但缺乏足够的监测和反馈。本研究旨在从常规收集的电子记录中找出实用的措施，以实现自动监控，并为PHC设置的hl管理提供持续优化的信息。方法：采用随机抽取的PHC电子病历（来自中国安徽省全省数据中心）作为主要数据源，生成基于程序和基于遭遇的方法来评估hl管理。基于程序的测量方法采用自行设计的算法，从21个阶段/程序（例如降脂药物处方）的特定质量事实中得出。而基于就诊的措施包括HL、当前注意到的高脂血症（CNHL，或当前咨询期间注意到的高脂血症）和已诊断的高脂血症（EDHL）的就诊次数或就诊率。对这些指标的分析主要采用简单描述和线性回归模型。结果：研究发现：不同地区之间HL患者和EDHL/CNHL患者的诊疗率（分别为0.01 ~ 1.43%和0.13% ~ 20.54%或0.02 ~ 2.99%）较低且差异较大；EDHL患者与CNHL患者的平均或累计就诊比例在临床医生组之间存在较大差异（5.14至22.20倍）；在研究期间，HL在全因就诊中的比例持续增加（从0.087到1.000%），同时CNHL/EDHL患者的比例相对稳定；在基于程序的测量中得分相对较低（特定程序按季节从0.00到36.08%不等）。结论：所确定的措施不仅从现实世界的PHC记录中是可行的，而且还提供了一些有用的指标，说明当前的hl管理情况如何以及未来需要采取哪些行动。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lipids in Health and Disease 生物-生化与分子生物学

CiteScore

7.70

自引率

2.20%

发文量

122

审稿时长

3-8 weeks

期刊介绍： Lipids in Health and Disease is an open access, peer-reviewed, journal that publishes articles on all aspects of lipids: their biochemistry, pharmacology, toxicology, role in health and disease, and the synthesis of new lipid compounds. Lipids in Health and Disease is aimed at all scientists, health professionals and physicians interested in the area of lipids. Lipids are defined here in their broadest sense, to include: cholesterol, essential fatty acids, saturated fatty acids, phospholipids, inositol lipids, second messenger lipids, enzymes and synthetic machinery that is involved in the metabolism of various lipids in the cells and tissues, and also various aspects of lipid transport, etc. In addition, the journal also publishes research that investigates and defines the role of lipids in various physiological processes, pathology and disease. In particular, the journal aims to bridge the gap between the bench and the clinic by publishing articles that are particularly relevant to human diseases and the role of lipids in the management of various diseases.