The Impact of Market Factors on Meaningful Use of Electronic Health Records Among Primary Care Providers: Evidence From Florida Using Resource Dependence Theory and Information Uncertainty Perspective.

IF 3.3 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Medical Care Pub Date : 2024-04-01 Epub Date: 2024-02-27 DOI:10.1097/MLR.0000000000001980
Pierre K Alexandre, Judith P Monestime, Kessie Alexandre
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引用次数: 0

Abstract

Background: Using federal funds from the 2009 Health Information Technology for Economic and Clinical Health Act, the Centers for Medicare and Medicaid Services funded the 2011-2021 Medicaid electronic health record (EHR) incentive programs throughout the country.

Objective: Identify the market factors associated with Meaningful Use (MU) of EHRs after primary care providers (PCPs) enrolled in the Florida-EHR incentives program through Adopting, Improving, or Upgrading (AIU) an EHR technology.

Research design: Retrospective cohort study using 2011-2018 program records for 8464 Medicaid providers.

Main outcome: MU achievement after first-year incentives.

Independent variables: The resource dependence theory and the information uncertainty perspective were used to generate key-independent variables, including the county's rurality, educational attainment, poverty, health maintenance organization penetration, and number of PCPs per capita.

Analytical approach: All the county rates were converted into 3 dichotomous measures corresponding to high, medium, and low terciles. Descriptive and bivariate statistics were calculated. A generalized hierarchical linear model was used because MU data were clustered at the county level (level 2) and measured at the practice level (level 1).

Results: Overall, 41.9% of Florida Medicaid providers achieved MU after receiving first-year incentives. Rurality was positively associated with MU ( P <0.001). Significant differences in MU achievements were obtained when we compared the "high" terciles with the "low" terciles for poverty rates ( P =0.002), health maintenance organization penetration rates ( P =0.02), and number of PCPs per capita ( P =0.01). These relationships were negative.

Conclusions: Policy makers and health care managers should not ignore the contribution of market factors in EHR adoption.

市场因素对初级保健提供者有效使用电子健康记录 (EHR) 的影响:利用资源依赖理论和信息不确定性视角分析佛罗里达州的证据。
背景:医疗保险与医疗补助服务中心利用 2009 年《经济与临床健康信息技术法案》中的联邦基金,在全国范围内资助了 2011-2021 年医疗补助电子健康记录(EHR)激励项目:确定初级保健提供者(PCP)通过采用、改进或升级(AIU)电子病历技术加入佛罗里达州电子病历激励计划后,与电子病历 "有意义使用"(MU)相关的市场因素:研究设计:使用 2011-2018 年 8464 名医疗补助提供者的计划记录进行回顾性队列研究:自变量:资源依赖理论和信息不确定性:自变量:采用资源依赖理论和信息不确定性视角生成关键自变量,包括县的乡村化程度、教育程度、贫困程度、健康维护组织渗透率和人均初级保健医生数量:分析方法:将所有县的比率转换成 3 个二分法,分别对应于高、中、低三个三等分位数。计算描述性和双变量统计。由于 MU 数据在县级(第 2 层)进行聚类,并在实践层面(第 1 层)进行测量,因此使用了广义分层线性模型:总体而言,41.9% 的佛罗里达医疗补助提供者在接受第一年激励后实现了 MU。结果:总体而言,41.9% 的佛罗里达医疗补助提供者在接受第一年激励后实现了 MU:政策制定者和医疗管理者不应忽视市场因素在电子健康记录采用中的作用。
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来源期刊
Medical Care
Medical Care 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.20
自引率
3.30%
发文量
228
审稿时长
3-8 weeks
期刊介绍: Rated as one of the top ten journals in healthcare administration, Medical Care is devoted to all aspects of the administration and delivery of healthcare. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of healthcare. This timely journal reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services.
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