The Ohio State University, College of Medicine, 2231 North High St., Rm, Columbus, OH, 266, USA.
Health Care Manag Sci. 2018 Sep;21(3):426-438. doi: 10.1007/s10729-017-9396-4. Epub 2017 Feb 24.
The federal government allocated nearly $30 billion to spur the development of information technology infrastructure capable of supporting the exchange of interoperable clinical data, leading to growth in hospital participation in health information exchange (HIE) networks. HIEs have the potential to improve care coordination across healthcare providers, leading ultimately to increased productivity of health services for hospitals. However, the impact of HIE participation on hospital efficiency remains unclear. This dynamic prompts the question asked by this study: does HIE participation improve hospital efficiency. This study estimates the effect of HIE participation on efficiency using a national sample of 1017 hospitals from 2009 to 2012. Using a two-stage analytic design, efficiency indices were determined using the Malmquist algorithm and then regressed on a set of hospital characteristics. Results suggest that any participation in HIE can improve both technical efficiency change and total factor productivity (TFP). A second model examining total years of HIE participation shows a benefit of one and three years of participation on TFP. These results suggest that hospital investment in HIE participation may be a useful strategy to improve hospital operational performance, and that policy should continue to support increased participation and use of HIE. More research is needed to identify the exact mechanisms through which HIE participation can improve hospital efficiency.
联邦政府拨款近 300 亿美元，以促进信息技术基础设施的发展，使其能够支持可互操作的临床数据交换，从而促使医院更多地参与健康信息交换 (HIE) 网络。HIE 有可能改善医疗服务提供者之间的协调，最终提高医院卫生服务的生产力。然而，HIE 参与对医院效率的影响尚不清楚。这种动态引发了本研究提出的问题：HIE 参与是否能提高医院效率。本研究使用 2009 年至 2012 年期间来自 1017 家医院的全国样本，采用两阶段分析设计，使用 Malmquist 算法确定效率指数，然后回归一组医院特征。结果表明，HIE 的任何参与都可以提高技术效率变化和总要素生产率 (TFP)。第二个模型检验了 HIE 参与的总年限，表明参与一年和三年对 TFP 有好处。这些结果表明，医院投资于 HIE 参与可能是改善医院运营绩效的有效策略，政策应继续支持增加 HIE 的参与和使用。需要进一步研究确定 HIE 参与可以提高医院效率的确切机制。
