• Atencion primaria · Jan 2021

    Observational Study

    [Does the Electronic Health Record reflect the social determinants of health from Primary Health Care?]

    • Marta Jiménez Carrillo, Joanna Fernández Rodker, Sastre PazMartaMSubdirección General de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, Madrid, España., and Ángel Alberquilla Menendez-Asenjo.
    • Unidad Docente Multiprofesional de Atención Familiar y Comunitaria Centro, SERMAS, Madrid, España. Electronic address: mjcarrillo@salud.madrid.org.
    • Aten Primaria. 2021 Jan 1; 53 (1): 36-42.

    ObjectiveAnalyze whether the use of Z codes in the Electronic Health Record (EHR) correlates with the socioeconomic reality of the population attended.DesignObservational, descriptive, cross-sectional, ecological study.Location90 health centres of two Primary Health Care (PHC) Departments of the Community of Madrid.ParticipantsThe total number of patients treated during 2016: 1,920,124 (54.33% women, 45.67% men). The 7.15% received some Z code (67.29% women, 32.71% men).Main MeasurementsAs a dependent variable, the proportion of patients with Z code records in their EHRs was established. As independent variable, two socioeconomic indicators were selected that objectively reflect the differences between Basic Health Areas: Average Income Available per capita and Proportion of Economic Immigrants. To evaluate the correlation between dependent and independent variables, a multivariate correlation-regression analysis was used.ResultsIt was observed that the higher the disposable income, the lower the proportion of Z code records in the EHRs (Pearson correlation coefficient: -0.56). However, there is a great variability in the registration of Z codes and the coding fails to make visible the socio-economic realities of the populations covered (Diagnostic Odds Ratio: 0.12. CI: 0.05-0.32).ConclusionsThe use of different tools that facilitate the visualization of the health impact of social inequalities, as well as their evaluation through various research methodologies, is relevant for a community orientation of the PHC. The Z codes do not make visible in the studied area the social determinants of health of the population attended.Copyright © 2020. Publicado por Elsevier España, S.L.U.

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