Kazley Abby S, Ozcan Yasar A
Medical University of South Carolina.
Med Care Res Rev. 2008 Aug;65(4):496-513. doi: 10.1177/1077558707313437. Epub 2008 Feb 14.
This study investigates how hospital electronic medical record (EMR) use influences quality performance. Data include nonfederal acute care hospitals in the United States. Sources of the data include the American Hospital Association, Hospital Quality Alliance, the Healthcare Information and Management Systems Society, and the Centers for Medicare and Medicaid Services case-mix index sets. The authors use a retrospective cross-sectional format with linear regression to assess the relationship between hospital EMR use and quality performance. Quality performance is measured using 10 process indicators related to 3 clinical conditions: acute myocardial infarction, congestive heart failure, and pneumonia. The authors also use a propensity score adjustment to control for possible selection bias. After this adjustment, the authors identify a positive significant relationship between EMR use and 4 of the 10 quality indicators. They conclude that there is limited evidence of the relationship between hospital EMR use and quality.
本研究调查了医院电子病历(EMR)的使用如何影响质量绩效。数据包括美国的非联邦急症护理医院。数据来源包括美国医院协会、医院质量联盟、医疗保健信息与管理系统协会以及医疗保险和医疗补助服务中心的病例组合指数集。作者采用回顾性横断面形式并结合线性回归来评估医院EMR使用与质量绩效之间的关系。质量绩效通过与3种临床病症(急性心肌梗死、充血性心力衰竭和肺炎)相关的10个过程指标来衡量。作者还使用倾向得分调整来控制可能的选择偏差。经过这种调整后,作者发现EMR使用与10个质量指标中的4个之间存在显著的正相关关系。他们得出结论,医院EMR使用与质量之间关系的证据有限。