Resnick Helaine E, Manard Barbara B, Stone Robyn I, Alwan Majd
Institute for the Future of Aging Services, American Association of Homes and Services for the Aging, 2519 Connecticut Avenue, NW Washington, DC 20008, USA.
J Am Med Inform Assoc. 2009 Mar-Apr;16(2):179-86. doi: 10.1197/jamia.M2955. Epub 2008 Oct 24.
This study sought to define the extent of utilization of 12 types of electronic information system (EIS) function in U.S. nursing homes (NH), to relate EIS utilization to selected facility characteristics and to contrast these findings to previous estimates of EIS use in NH.
This study used data from the National Nursing Home Survey (NNHS), a nationally representative, cross-sectional sample of U.S. NH.
Data on current use of EIS in 12 functional areas, including administrative and resident care activities, were collected. Information was also collected on facility characteristics including ownership, bed size, and whether the facility was a member of a chain.
Essentially all (99.6%) U.S. NH had >or=1 EIS, a figure that was driven by the nearly universal use of EIS for Minimum Data Set (MDS) reporting (96.4%) and for billing (95.4%). Nearly 43% of U.S. NH had EIS for medical records, including nurse's notes, physician notes, and MDS forms. EIS use ranged from a high of 79.6% for admission, transfer, and discharge to a low of 17.6% for daily care by certified nursing assistants (CNAs). Ownership, membership in a chain, and bed size were associated with use of selected EIS. Larger facilities and those that were part of a chain used more EIS than smaller standalone facilities.
In 2004, NH use of EIS for functions other than MDS and billing was highly variable, but considerably higher than previous estimates.
本研究旨在确定美国养老院(NH)中12种电子信息系统(EIS)功能的使用程度,将EIS的使用情况与选定的机构特征相关联,并将这些结果与之前对NH中EIS使用情况的估计进行对比。
本研究使用了来自美国国家养老院调查(NNHS)的数据,该调查是美国NH的一个具有全国代表性的横断面样本。
收集了关于EIS在12个功能领域当前使用情况的数据,包括行政和居民护理活动。还收集了关于机构特征的信息,包括所有权、床位规模以及该机构是否为连锁机构的成员。
基本上所有(99.6%)的美国NH都拥有≥1种EIS,这一数字是由EIS在最低数据集(MDS)报告(96.4%)和计费(95.4%)方面几乎普遍的使用所驱动的。近43%的美国NH拥有用于医疗记录的EIS,包括护士记录、医生记录和MDS表格。EIS的使用范围从入院、转院和出院时的79.6%的高使用率到经认证的护理助理(CNA)日常护理时的17.6%的低使用率。所有权、连锁机构成员身份和床位规模与选定EIS的使用相关。较大的机构以及那些属于连锁机构的机构比较小的独立机构使用更多的EIS。
2004年,NH在MDS和计费以外功能上对EIS的使用差异很大,但远高于之前的估计。