Hu Xuejun, Qu Haiyan, Houser Shannon H, Chen Huoliang, Zhou Jinming, Yu Min
Department of Health Services Administration, Air Force Medical University, Xi'an, People's Republic of China.
Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, USA.
Risk Manag Healthc Policy. 2020 Apr 2;13:295-301. doi: 10.2147/RMHP.S241553. eCollection 2020.
The aim of this study was to explore the relationship between hospital characteristics and certified electronic health record (EHR) adoption in psychiatric hospitals in the US.
Data were drawn from the American Hospital Association Annual Survey Database and the Centers for Medicare and Medicaid Services Hospital Compare data sets in 2016. Binary logistic regression analysis and tests were performed to examine the relationship between certified EHR adoption and hospital characteristics.
Of 1,059 psychiatric hospitals in the US, 502 (47.4%) have adopted certified EHR technology. Large hospitals (OR 2.29, 95% CI 1.52-3.44; <0.001), not-for-profit hospitals (OR 1.74, 95% CI 1.22-2.49; =0.008), and hospitals participating in a network (OR 1.78, 95% CI 1.34-2.37; <0.001) were more likely to adopt certified EHRs. Hospitals in the northeast were less likely to implement certified EHRs compared to other regions. However, there was no significant association found between EHR utilization and system affiliation, urban location, teaching status, or participation of health-maintenance organizations and preferred provider organizations.
The study results suggested variations in EHR adoption according to hospital location, size, ownership, and network participation. This study fills a gap in previous work on certified EHR adoption that focused exclusively on general hospitals, but overlooked psychiatric hospitals. Future policies designed to influence the implementation of certified EHRs should take into consideration how hospital size, ownership, and network-affiliation status affect certified EHR adoption among psychiatric hospitals.
本研究旨在探讨美国精神病医院的医院特征与认证电子健康记录(EHR)采用情况之间的关系。
数据来源于2016年美国医院协会年度调查数据库和医疗保险与医疗补助服务中心医院比较数据集。进行二元逻辑回归分析和检验,以研究认证EHR采用情况与医院特征之间的关系。
在美国的1059家精神病医院中,502家(47.4%)采用了认证EHR技术。大型医院(比值比[OR]2.29,95%置信区间[CI]1.52 - 3.44;P<0.001)、非营利性医院(OR 1.74,95% CI 1.22 - 2.49;P = 0.008)以及参与网络的医院(OR 1.78,95% CI 1.34 - 2.37;P<0.001)更有可能采用认证EHR。与其他地区相比,东北部的医院采用认证EHR的可能性较小。然而,EHR使用情况与系统隶属关系、城市位置、教学状况或健康维护组织及优选提供者组织的参与情况之间未发现显著关联。
研究结果表明,根据医院位置、规模、所有权和网络参与情况,EHR采用情况存在差异。本研究填补了以往关于认证EHR采用情况的研究空白,以往研究仅关注综合医院,而忽视了精神病医院。未来旨在影响认证EHR实施的政策应考虑医院规模、所有权和网络隶属状况如何影响精神病医院认证EHR的采用。