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- Title
The interaction between high-level electronic medical record adoption and hospitalist staffing levels: A focus on value-based purchasing.
- Authors
Li, Kate Jiayi; Al-Amin, Mona
- Abstract
Objective: This study sought to understand the relationship of hospital performance with high-level electronic medical record (EMR) adoption, hospitalists staffing levels, and their potential interaction. Materials and methods: We evaluated 2,699 non-federal, general acute hospitals using 2016 data merged from four data sources. We performed ordinal logistic regression of hospitals' total performance score (TPS) on their EMR capability and hospitalists staffing level while controlling for other market- and individual-level characteristics. Results: Hospitalists staffing level is shown to be positively correlated with TPS. High-level EMR adoption is associated with both short-term and long-term improvement on TPS. Large, urban, non-federal government hospitals, and academic medical centers tend to have lower TPS compared to their respective counterparts. Hospitals belonging to medium- or large-sized healthcare systems have lower TPS. Higher registered nurse (RN) staffing level is associated with higher TPS, while higher percentage of Medicare or Medicaid share of inpatient days is associated with lower TPS. Discussion: Although the main effects of hospitalists staffing level and EMR capability are significant, their interaction is not, suggesting that hospitalists and EMR act through separate mechanisms to help hospitals achieve better performance. When hospitals are not able to invest on both simultaneously, given financial constraints, they can still reap the full benefits from each. Conclusion: Hospitalists staffing level and EMR capability are both positively correlated with hospitals' TPS, and they act independently to bolster hospital performance.
- Subjects
KRUSKAL-Wallis Test; EVALUATION of medical care; ELECTRONIC data interchange; ANALYSIS of variance; REGRESSION analysis; MEDICAL care costs; VALUE-based healthcare; HEALTH insurance reimbursement; ORGANIZATIONAL effectiveness; QUALITY assurance; CHI-squared test; ELECTRONIC health records; LOGISTIC regression analysis
- Publication
Health Services Management Research, 2022, Vol 35, Issue 2, p66
- ISSN
0951-4848
- Publication type
Article
- DOI
10.1177/09514848211001696