高水平电子病历采用与医院人员配备水平之间的相互作用:关注基于价值的采购。

IF 1.6 Q3 HEALTH POLICY & SERVICES
Health Services Management Research Pub Date : 2022-05-01 Epub Date: 2021-03-16 DOI:10.1177/09514848211001696
Kate Jiayi Li, Mona Al-Amin
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引用次数: 0

摘要

目的:本研究旨在了解医院绩效与高水平电子病历(EMR)采用、医院人员配备水平及其潜在相互作用的关系。材料和方法:我们使用来自四个数据源合并的2016年数据评估了2,699家非联邦普通急性医院。在控制其他市场和个人水平特征的同时,我们对医院的总绩效得分(TPS)对其EMR能力和医院人员配备水平进行了有序逻辑回归。结果:医院人员配备水平与TPS呈正相关。高水平的电子病历采用与TPS的短期和长期改善有关。大型、城市、非联邦政府医院和学术医疗中心的TPS与各自的同行相比往往较低。大中型医疗机构的医院TPS较低。较高的注册护士(RN)人员配备水平与较高的TPS相关,而较高的医疗保险或医疗补助住院天数份额与较低的TPS相关。讨论:虽然医院人员配备水平和EMR能力的主要影响是显著的,但它们之间的相互作用并不显著,这表明医院人员和EMR通过不同的机制来帮助医院实现更好的绩效。当医院由于财政限制而无法同时投资于这两项时,它们仍然可以从每项中获得全部收益。结论:医院人员配备水平和EMR能力与医院TPS均呈正相关,且两者独立作用于医院绩效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The interaction between high-level electronic medical record adoption and hospitalist staffing levels: A focus on value-based purchasing.

Objective: This study sought to understand the relationship of hospital performance with high-level electronic medical record (EMR) adoption, hospitalists staffing levels, and their potential interaction.

Materials and methods: We evaluated 2,699 non-federal, general acute hospitals using 2016 data merged from four data sources. We performed ordinal logistic regression of hospitals' total performance score (TPS) on their EMR capability and hospitalists staffing level while controlling for other market- and individual-level characteristics.

Results: Hospitalists staffing level is shown to be positively correlated with TPS. High-level EMR adoption is associated with both short-term and long-term improvement on TPS. Large, urban, non-federal government hospitals, and academic medical centers tend to have lower TPS compared to their respective counterparts. Hospitals belonging to medium- or large-sized healthcare systems have lower TPS. Higher registered nurse (RN) staffing level is associated with higher TPS, while higher percentage of Medicare or Medicaid share of inpatient days is associated with lower TPS.

Discussion: Although the main effects of hospitalists staffing level and EMR capability are significant, their interaction is not, suggesting that hospitalists and EMR act through separate mechanisms to help hospitals achieve better performance. When hospitals are not able to invest on both simultaneously, given financial constraints, they can still reap the full benefits from each.

Conclusion: Hospitalists staffing level and EMR capability are both positively correlated with hospitals' TPS, and they act independently to bolster hospital performance.

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来源期刊
Health Services Management Research
Health Services Management Research HEALTH POLICY & SERVICES-
CiteScore
4.00
自引率
4.80%
发文量
33
期刊介绍: Health Services Management Research (HSMR) is an authoritative international peer-reviewed journal which publishes theoretically and empirically rigorous research on questions of enduring interest to health-care organizations and systems throughout the world. Examining the real issues confronting health services management, it provides an independent view and cutting edge evidence-based research to guide policy-making and management decision-making. HSMR aims to be a forum serving an international community of academics and researchers on the one hand and healthcare managers, executives, policymakers and clinicians and all health professionals on the other. HSMR wants to make a substantial contribution to both research and managerial practice, with particular emphasis placed on publishing studies which offer actionable findings and on promoting knowledge mobilisation toward theoretical advances.
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