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The impact of patient-held health records on continuity of care among asylum seekers in reception centres: a cluster-randomised stepped wedge trial in Germany
- Source :
- BMJ Global Health
- Publication Year :
- 2019
- Publisher :
- BMJ Publishing Group, 2019.
-
Abstract
- IntroductionThe aim of this study was to assess the effectiveness of a patient-held health record (PHR) for asylum seekers on the availability of health-related information.MethodsAn explorative, cluster-randomised stepped-wedge trial with reception centres as unit of randomisation was conducted. All reception centres (n=6) in two large administrative areas in South Germany with on-site health services were included. All physicians working at these centres were invited to participate in the study. The intervention was the implementation of a PHR. The primary outcome was the prevalence of written health-related information. Secondary outcomes were the physicians’ dissatisfaction with the available written information and the prevalence of missing health-related information. All outcomes were measured at the level of patient–physician contacts by means of a standardised questionnaire, and analysed in logistic multi-level regression models.ResultsWe obtained data on 2308 patient–physician contacts. The presence of the PHR increased the availability of health-related information (adjusted OR (aOR), 20.3, 95% CI: 12.74 to 32.33), and tended to reduce missing essential information (aOR 0.71, 95% CI: 0.39 to 1.26) and physicians’ dissatisfaction with available information (aOR 0.5, 95% CI: 0.24 to 1.04). The availability of health-related information in the post-intervention period was higher (aOR 4.22, 95% CI: 2.64 to 6.73), missing information (aOR 0.89, 95% CI: 0.42 to 1.88) and dissatisfaction (aOR 0.43, 95% CI: 0.16 to 1.14) tended to be lower compared with the pre-intervention period.ConclusionsHealthcare planners should consider introducing PHRs in reception centres or comparable facilities. Future research should focus on the impact of PHRs on clinical outcomes and on intersectoral care.Trial registrationISRCTN13212716. Registered 24 November 2016. Retrospectively registered. http://www.isrctn.com/ISRCTN13212716
- Subjects :
- medicine.medical_specialty
Refugee
cluster randomisation
Disease cluster
migration
medical record
stepped-wedge trial
03 medical and health sciences
health record
0302 clinical medicine
Intervention (counseling)
Health care
Epidemiology
medicine
030212 general & internal medicine
health services
business.industry
Health Policy
Medical record
Public health
Research
Public Health, Environmental and Occupational Health
refugees
continuity
health information
Family medicine
Rural area
business
030217 neurology & neurosurgery
asylum seekers
Subjects
Details
- Language :
- English
- ISSN :
- 20597908
- Volume :
- 4
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- BMJ Global Health
- Accession number :
- edsair.doi.dedup.....ef55b45f2b6b5b6d37350a7dfe0bd3da