Selck Frederic W, Decker Sandra L
Bates White Economic Consulting, 1300 Eye Street NW, Suite 600, Washington, DC 20005.
National Center for Health Statistics, Hyattsville, MD.
Health Serv Res. 2016 Feb;51(1):32-47. doi: 10.1111/1475-6773.12307. Epub 2015 Apr 8.
To describe the trend in health information technology (IT) systems adoption in hospital emergency departments (EDs) and its effect on ED efficiency and resource use.
2007-2010 National Hospital Ambulatory Medical Care Survey - ED Component.
We assessed changes in the percent of visits to EDs with health IT capability and the estimated effect on waiting time to see a provider, visit length, and resource use.
The percent of ED visits that took place in an ED with at least a basic health IT or an advanced IT system increased from 25.2 and 3.1 percent in 2007 to 69.1 and 30.6 percent in 2010, respectively (p < .05). Controlling for ED fixed effects, waiting times were reduced by 6.0 minutes in advanced IT-equipped EDs (p < .05), and the number of tests ordered increased by 9 percent (p < .01). In models using a 1-year lag, advanced systems also showed an increase in the number of medications and images ordered per visit.
Almost a third of visits now occur in EDs with advanced IT capability. While advanced IT adoption may decrease wait times, resource use during ED visits may also increase depending on how long the system has been in place. We were not able to determine if these changes indicated more appropriate care.
描述医院急诊科采用健康信息技术(IT)系统的趋势及其对急诊科效率和资源利用的影响。
2007 - 2010年国家医院门诊医疗调查 - 急诊科部分。
我们评估了具备健康IT能力的急诊科就诊百分比的变化,以及对看诊等待时间、就诊时长和资源利用的估计影响。
在至少配备基本健康IT或先进IT系统的急诊科进行的就诊百分比,分别从2007年的25.2%和3.1%增至2010年的69.1%和30.6%(p <.05)。在控制急诊科固定效应后,配备先进IT的急诊科等待时间减少了6.0分钟(p <.05),所开检查单数量增加了9%(p <.01)。在使用1年滞后的模型中,先进系统还显示每次就诊所开药物和影像单数量有所增加。
目前近三分之一的就诊发生在具备先进IT能力的急诊科。虽然采用先进IT可能会减少等待时间,但根据系统启用时长,急诊科就诊期间的资源利用也可能增加。我们无法确定这些变化是否表明提供了更恰当的医疗服务。