Comprehensive Electronic Medical Record Implementation Levels not Associated with 30-Day All-Cause Read-Missions within Medicare Beneficiaries with Heart Failure
| Autor: | S. D. Simon, Y. Zhong, P. A. Marken, M. E. Patterson, W. Ketcherside |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
media_common.quotation_subject Beneficiary Health Informatics Medicare 01 natural sciences Patient Readmission 03 medical and health sciences 0302 clinical medicine Patient Admission Health Information Management medicine Prevalence Electronic Health Records Humans 030212 general & internal medicine 0101 mathematics media_common Retrospective Studies Selection bias Heart Failure Inpatient care business.industry 010102 general mathematics Hazard ratio Retrospective cohort study Kansas Length of Stay medicine.disease United States Computer Science Applications Heart failure Ambulatory Emergency medicine Propensity score matching Medical emergency business Research Article |
| Popis: | SummaryBackground: Regulatory standards for 30-day readmissions incentivize hospitals to improve quality of care. Implementing comprehensive electronic health record systems potentially decreases readmission rates by improving medication reconciliation at discharge, demonstrating the additional benefits of inpatient EHRs beyond improved safety and decreased errors.Objective: To compare 30-day all-cause readmission incidence rates within Medicare fee-for-service with heart failure discharged from hospitals with full implementation levels of comprehensive EHR systems versus those without.Methods: This retrospective cohort study uses data from the American Hospital Association Health IT survey and Medicare Part A claims to measure associations between hospital EHR implementation levels and beneficiary readmissions. Multivariable Cox regressions estimate the hazard ratio of 30-day all-cause readmissions within beneficiaries discharged from hospitals implementing comprehensive EHRs versus those without, controlling for beneficiary health status and hospital organizational factors. Propensity scores are used to account for selection bias.Results: The proportion of heart failure patients with 30-day all-cause readmissions was 30%, 29%, and 32% for those discharged from hospitals with full, some, and no comprehensive EHR systems. Heart failure patients discharged from hospitals with fully implemented comprehensive EHRs compared to those with no comprehensive EHR systems had equivalent 30-day readmission incidence rates (HR = 0.97, 95% CI 0.73 – 1.3)Conclusions: Implementation of comprehensive electronic health record systems does not necessarily improve a hospital’s ability to decrease 30-day readmission rates. Improving the efficiency of post-acute care will require more coordination of information systems between inpatient and ambulatory providers.Citation: Patterson ME, Marken P, Zhong Y, Simon SD, Ketcherside W. Comprehensive electronic medical record implementation levels not associated with 30-day all-cause readmissions within Medicare beneficiaries with heart failure. Appl Clin Inf 2014; 5: 670–684http://dx.doi.org/10.4338/ACI-2014-01-RA-0008 |
| Databáze: | OpenAIRE |
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