Choi Jae-Young, Kuo Yong-Fang, Goodwin James S, Lee Jinhyung
Program in Healthcare Management, College of Business, Hallym University, Chuncheon, Korea.
Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Healthc Inform Res. 2016 Apr;22(2):101-9. doi: 10.4258/hir.2016.22.2.101. Epub 2016 Apr 30.
Disparities in healthcare among minority groups can result in disparate treatments for similar severities of symptoms, unequal access to medical care, and a wide deviation in health outcomes. Such racial disparities may be reduced via use of an Electronic Medical Record (EMR) system. However, there has been little research investigating the impact of EMR systems on the disparities in health outcomes among minority groups.
This study examined the impact of EMR systems on the following four outcomes of black patients: length of stay, inpatient mortality rate, 30-day mortality rate, and 30-day readmission rate, using patient and hospital data from the Medicare Provider Analysis and Review and the Healthcare Information and Management Systems Society between 2000 and 2007. The difference-in-difference research method was employed with a generalized linear model to examine the association of EMR adoption on health outcomes for minority patients while controlling for patient and hospital characteristics.
We examined the association between EMR adoption and the outcomes of minority patients, specifically black patients. However, after controlling for patient and hospital characteristics we could not find any significant changes in the four health outcomes of minority patients before and after EMR implementation.
EMR systems have been reported to support better coordinated care, thus encouraging appropriate treatment for minority patients by removing potential sources of bias from providers. Also, EMR systems may improve the quality of care provided to patients via increased responsiveness to care processes that are required to be more time-sensitive and through improved communication. However, we did not find any significant benefit for minority groups after EMR adoption.
少数群体在医疗保健方面的差异可能导致对相似症状严重程度的不同治疗、获得医疗服务的机会不平等以及健康结果的巨大偏差。通过使用电子病历（EMR）系统，这种种族差异可能会减少。然而，很少有研究调查EMR系统对少数群体健康结果差异的影响。
本研究使用2000年至2007年间医疗保险提供者分析与审查以及医疗保健信息与管理系统协会的患者和医院数据，研究了EMR系统对黑人患者的以下四个结果的影响：住院时间、住院死亡率、30天死亡率和30天再入院率。采用差异中的差异研究方法和广义线性模型，在控制患者和医院特征的同时，研究采用EMR与少数族裔患者健康结果之间的关联。
我们研究了采用EMR与少数族裔患者（特别是黑人患者）的结果之间的关联。然而，在控制了患者和医院特征后，我们没有发现实施EMR前后少数族裔患者的四项健康结果有任何显著变化。
据报道，EMR系统有助于更好地协调护理，从而通过消除提供者潜在的偏见来源，鼓励对少数族裔患者进行适当治疗。此外，EMR系统可能通过提高对需要更具时间敏感性的护理过程的响应能力以及改善沟通，提高提供给患者的护理质量。然而，我们没有发现采用EMR后少数群体有任何显著益处。
