Development of Informatization in Primary Care in China's Regions Inhabited by Ethnic Minorities

Abstract

Background The rapid development of informatization in primary care in regions inhabited by ethnic minorities during the 13th Five-Year Plan period (2016—2020) , has laid a foundation for the improvement of the serving capacity of primary care supported by information technologies, but there is a lack of research on information technology and the efficiency of primary care. Objective To assess the status including effectiveness of informatization in primary care in China asregions inhabited by ethnic minorities, to explore the impact of information technology on improving the efficiency of primary care. Methods From July to October 2020, 84 primary care institutions in 23 ethnic counties in three autonomous prefectures of Sichuan (Ganzi, Liangshan and Aba) were selected by stratified sampling, and whose directors were invited to complete a self-administered questionnaire survey for understanding the status including effectiveness of informatization in their institutions. Furthermore, the heads of local health committees and directors of primary care institutions in these ethnic counties were invited to attend a group discussion regardingthe setting of departments, service development, status of informatization and settings for information services in primary care institutions. Results In terms of software construction, of the 84 primary care institutions, 57 (67.9%) used the public health system, 44 (52.4%) used the family doctor management system, and 25 (29.8%) use the hospital information system. Forty-seven (56.0%) primary care institutions had achieved vertical connectivity with other institutions (mostly regional- and county-level institutions as well as other members in a regional medical consortium) using information technologies, and regional informatization. Institutions that had horizontal connectivity with 69 (74.4%) of the primary care institutions were medical insurance departments. Only 18 (21.4%) institutions had independent information departments, and 34 (41.0%) did not employ information professionals. Lack of information professionals〔64 (76.2%) 〕, insufficient funds〔52 (61.9%) 〕 and weak infrastructure〔51 (60.7%) 〕 were main problems revealed in informatization construction. Institutions with regional informatization, vertical connectivity with other institutions, and the construction of a hospital information platform with electronic medical record system as the core were superior to those without in terms of setting of laboratory and examination departments and provision of traditional Chinese medicine services (P<0.05) . According to the group discussion, the institutions had basically completed the construction of information standardization, with well-equipped hardware facilities, health informatization-derived management efficiencies, such as improved efficiency, increased scope of supervision, refined supervision, scientific decision-making and digital governance, and service potencies, such as increased efficiency, accessibility and quality of services. Conclusion Information technology could greatly contribute to the solving of bottleneck during services delivery in primary care in regions inhabited by ethnic minorities, which has promoted the setting of departments and service extension, and improved the accessibility of health services, as well as the innovation in service delivery modes in these institutions. Problems identified in the informatization construction include insufficient investment in informatization operation and maintenance, insufficient application and lack of information professionals. In view of this, it is suggested to strengthen the investment in informatization construction in primary care, establish a standardized and applicable health informatization training mechanism, pay attention to the construction of a health information talent team, and deepen the intelligent application of information technology in primary care services.

Keywords

• primary health care institutions|hospital information systems|information efficiency|ethnic areas