Effect of computerized physician order entry inactivation to order complementary studies in an emergency department
| Autor: | Muñoz AM; Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina.. agustin.munoz@hospitalitaliano.org.ar., Frutos EL; Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina.. eliana.frutos@hospitalitaliano.org.ar., Pedretti AS; Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina.. ana.pedretti@hospitalitaliano.org.ar., Pollan JA; Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina.. javier.pollan@hospitalitaliano.org.ar., Luna DR; Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina.. daniel.luna@hospitalitaliano.org.ar., Martínez BJ; Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina.. bernardo.martinez@hospitalitaliano.org.ar., Grande Ratti MF; Hospital Italiano de Buenos Aires, Ciudad de Buenos Aires, Argentina.. maria.grande@hospitalitaliano.org.ar. |
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| Jazyk: | Spanish; Castilian |
| Zdroj: | Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina) [Rev Fac Cien Med Univ Nac Cordoba] 2023 Mar 31; Vol. 80 (1), pp. 29-35. Date of Electronic Publication: 2023 Mar 31. |
| DOI: | 10.31053/1853.0605.v80.n1.36760 |
| Abstrakt: | Introduction: The computerized provider order entry (CPOE) is a computing tool that could lead to unintended consequences despite its myriad benefits. We aimed to explore the effect of its inactivation on requests for complementary studies and the associated costs. Methods: Cross sectional study at the Emergency Department of Hospital Italiano de Buenos Aires, which included a consecutive sample of pre-intervention (January-February 2020) and post-intervention (2021) consultations. Using secondary bases, the variables included were administrative debits and their respective billing prices. Results: There were 27,671 consultations in 2020 with a total median value of $474, and 20,819 with $1,639 in 2021. After the analysis restricted to the area of moderately complex clinics (excluding COVID-19 consultations), the following was found: a decrease in the median number of practices per consultation (median of 11 vs. 10, p=0.001), a decrease in the request for at least one laboratory practice (45% vs. 39%, p=0.001), without finding significant changes in global costs (median $1,419 vs. $1,081; p=0.122) or in specific laboratory costs (median $1,071 vs. $1,089, p=0.710). Conclusion: Despite inflation, a significant reduction in the number of practices was achieved and overall costs per consultation were maintained. These findings demonstrate the effectiveness of the intervention, but an educational intervention aimed at reminding the potential harm of overuse and the health costs of unnecessary studies will be necessary. (Universidad Nacional de Córdoba) |
| Databáze: | MEDLINE |
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