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BMC Health Services Research

, 13:39

Quality, performance, safety and outcomes


BackgroundThe electronic medical record EMR is one of the most promising components of health information technology. However, the overall impact of EMR adoption on outcomes at US hospitals remains unknown. This study examined the relationship between basic EMR adoption and 30-day rehospitalization, 30-day mortality, inpatient mortality and length of stay.

MethodsOur overall approach was to compare outcomes for the two years before and two years after the year of EMR adoption, at 708 acute-care hospitals in the US from 2000 to 2007. We looked at the effect of EMR on outcomes using two methods. First, we compared the outcomes by quarter for the period before and after EMR adoption among hospitals that adopted EMR. Second, we compared hospitals that adopted EMR to those that did not, before and after EMR adoption, using a generalized linear model.

ResultsHospitals adopting EMR experienced 0.11 95% CI: -0.218 to −0.002 days’ shorter length of stay and 0.182 percent lower 30-day mortality, but a 0.19 95% CI: 0.0006 to 0.0033 percent increase in 30-day rehospitalization in the two years after EMR adoption. The association of EMR adoption with outcomes also varied by type of admission medical vs. surgical.

ConclusionsPrevious studies using observational data from large samples of hospitals have produced conflicting results. However, using different methods, we found a small but statistically significant association of EMR adoption with outcomes of hospitalization.

KeywordsElectronic medical record EMR Length of stay Rehospitalization rates Diagnosis related groups DRG Electronic supplementary materialThe online version of this article doi:10.1186-1472-6963-13-39 contains supplementary material, which is available to authorized users.

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Autor: Jinhyung Lee - Yong-Fang Kuo - James S Goodwin


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