Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Denver, Aurora, CO 80045, USA.
Am J Manag Care. 2011 Mar 1;17(3):e66-70.
To investigate the relationship between the use of health information technology (HIT) and physician perceptions of providing high-quality care and to determine whether this relationship has changed over time.
We used 2 waves of longitudinal data from the Community Tracking Study Physician Surveys, 2000-2001 and 2004-2005.
Three measures of HIT were examined: a binary variable measuring the use of at least 1 type of HIT, a continuous variable measuring the total number of HIT types, and a binary variable measuring use of all 5 HIT types related to "meaningful use" of HIT as defined by Centers for Medicare and Medicaid Services. Three multivariate models were estimated to study the effect of each HIT measure on physicians' perception of providing high-quality care. Individual fixed-effects estimation also was used to control for individual time-invariant factors.
Using at least 1 type of HIT significantly enhanced physicians' perception of providing high-quality care in 2000-2001, but not in 2004-2005. The marginal effect of adding 1 extra HIT type was positive and statistically significant in both periods. The association between using all 5 HIT types related to meaningful use and perceived quality was statistically significant in 2000-2001, but not in 2004-2005.
Health information technology has become a multifunctional system and appears to have enhanced physicians' perception of providing high-quality care. Physicians' perceptions of medical care quality improved as the number of HIT types used increased. This study supports more extensive use of HIT in physician practices.
调查使用健康信息技术(HIT)与医生提供高质量医疗服务的认知之间的关系,并确定这种关系是否随时间而变化。
我们使用了来自社区跟踪研究医师调查的 2 个纵向数据波次,即 2000-2001 年和 2004-2005 年。
我们考察了 3 项 HIT 措施:使用至少 1 种 HIT 的二进制变量、测量 HIT 类型总数的连续变量,以及测量与医疗保险和医疗补助服务中心定义的“有意义使用”相关的所有 5 种 HIT 类型使用情况的二进制变量。我们使用了 3 个多变量模型来研究每种 HIT 措施对医生提供高质量医疗服务认知的影响。个体固定效应估计也被用来控制个体的时间不变因素。
在 2000-2001 年,使用至少 1 种 HIT 显著增强了医生提供高质量医疗服务的认知,但在 2004-2005 年没有。在这两个时期,增加 1 种额外 HIT 类型的边际效应均为正且具有统计学意义。在 2000-2001 年,使用与有意义使用相关的所有 5 种 HIT 类型与感知质量之间的关联具有统计学意义,但在 2004-2005 年没有。
健康信息技术已成为一种多功能系统,似乎增强了医生提供高质量医疗服务的认知。随着使用的 HIT 类型数量的增加,医生对医疗保健质量的认知得到了改善。本研究支持在医生实践中更广泛地使用 HIT。