The relationship between pediatric volume and information technology adoption in hospitals

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Menachemi, Nir PhD, MPH; Brooks, Robert G. MD, MBA; Simpson, Lisa MB, BCh, MPH, The Relationship Between Pediatric Volume and Information Technology Adoption in Hospitals. Quality Management in Health Care.2007; Volume16(2), April/June 2007; 146-152

Intoduction

The authors in this article are examining the IT adoption in acute care hospitals that take care of a large proportion of children below the age 18. There have been no studies done so far which examine patient characteristics of hospitals in health IT adoption. This study is a step forward to find relation if IT adoption would benefit and improve care among children.

Background

Children make a high percentage of a hospital’s discharge and IT may benefit more in the pediatric population as medical errors which can cause harm are 3 times more likely to occur in pediatric inpatients than adult patients. There has been evidence published in the past that IT improves the overall quality of health care in hospitals like the use of computerized physician order entry helped in decreasing medication errors and harmful adverse drug events.

Method

A survey was done in the acute care hospitals of Florida between May and October 2003 where the Chief Information Officers were contacted and were asked to participate in the study by filling out a questionnaire. Also, Florida discharge database was obtained from the Florida regulatory agency.

Results

The high volume pediatric discharges from hospitals showed more adoption of IT than the hospitals which had low volume of patient discharges. Statistical Analysis of the volume discharges was also done using chi square analysis. Another significant result found was that higher reliance of reimbursement by public insurance type was negatively related to IT adoption.

Discussion

The hospitals with higher pediatric volumes were more likely to adopt health IT but it is not clear by this study if the tailored IT specific for children needs like weight based dosing or children decision support applications are present in the hospitals with high pediatric discharges.

Also, there was a negative relation found between increase in the percentage of public insurance type and IT adoption which is plausible because of the lower reimbursements associated with state level public insurance types. After looking at the benefits of adopting health IT, lower levels of adoption who serve large populations raise questions regarding the quality of care and safety of patients.

Some of the limitations of this study were that it was non experimental and cross sectional in nature. There is a possibility of response bias and the study focused on acute care hospitals and not on specialty care.

Nitika Gupta

References

  1. http://www.ncbi.nlm.nih.gov/pubmed/17426613