Wang Nianyang, Albaroudi Asmaa, Benjenk Ivy, Chen Jie
Department of Health Policy and Management, University of Maryland, School of Public Health, College Park, MD, USA.
Prev Med Rep. 2021 Jun 23;23:101459. doi: 10.1016/j.pmedr.2021.101459. eCollection 2021 Sep.
This study investigated whether hospital-adopted health information technology (HIT) is associated with a reduction in the frequency of preventable emergency department (ED) visits for patients with Alzheimer's Disease and Related Dementias (ADRD). We used data from the 2015 State Emergency Department Databases, Area Health Resources File, and the American Hospital Association Annual Survey Information Technology Supplement. We employed multivariable logistic regression models to examine the variation of the likelihood of having preventable ED visits by hospitals' adoption of HIT functions and adjusted for patient, hospital, and county-level factors. We focused on hospital-HIT functions related to patient engagement, routine integration and availability of electronic clinical information, frequency of hospital reported use of electronic patient information, and the provision of electronic notification to the patient's primary care provider. Approximately 23% of ADRD patients went to a hospital that often used electronic records from outside providers, and 75% of ADRD patients went to a hospital that provided electronic notification to the patient's primary care provider. Regression results showed that hospital reported use of electronic patient health information from outside providers (OR = 0.88; p < 0.001), provision of electronic notification to the patient's primary care physician inside and outside of the system (OR = 0.91; p = 0.013), and hospital-HIT patient engagement functionalities (OR = 0.90; p < 0.001) were associated with significantly lower preventable ED visit rates. The results of our study suggest that certain types of HIT functionalities may be useful for reducing preventable ED visits for ADRD patients.
本研究调查了医院采用的健康信息技术(HIT)是否与阿尔茨海默病及相关痴呆症(ADRD)患者可预防的急诊科(ED)就诊频率降低有关。我们使用了2015年国家急诊科数据库、地区卫生资源文件以及美国医院协会年度调查信息技术补充资料中的数据。我们采用多变量逻辑回归模型,以检验医院采用HIT功能对可预防的ED就诊可能性的影响,并对患者、医院和县一级因素进行了调整。我们重点关注与患者参与度、电子临床信息的常规整合与可用性、医院报告的电子患者信息使用频率以及向患者的初级保健提供者提供电子通知相关的医院HIT功能。约23%的ADRD患者前往经常使用外部提供者电子记录的医院就诊,75%的ADRD患者前往向患者的初级保健提供者提供电子通知的医院就诊。回归结果显示,医院报告使用外部提供者的电子患者健康信息(OR = 0.88;p < 0.001)、向系统内外患者的初级保健医生提供电子通知(OR = 0.91;p = 0.013)以及医院HIT患者参与功能(OR = 0.90;p < 0.001)与可预防的ED就诊率显著降低相关。我们的研究结果表明,某些类型的HIT功能可能有助于降低ADRD患者可预防的ED就诊率。