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Will meaningful use electronic medical records reduce hospital costs?
William E Encinosa1, Jaeyong Bae
1Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, 540 Gaither Rd, Rockville, MD 20850.
Background:
More than one-third of the Centers for Medicare and Medicaid Services core meaningful use (MU) requirements deal with medication management.
Objectives:
To examine what impact the 5 core medication MU criteria have on hospital-acquired adverse drug events (ADEs) and their costs in 2010, as a baseline for the start of MU implementation in 2011.
Data Sources:
2010 Florida State Inpatient Database (Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality), American Hospital Association (AHA) Healthcare IT Database Supplement to the AHA 2010 Annual Survey of Hospitals, and Hospital Compare.
Methods:
We developed one of the first quality indicators to track in-hospital ADEs in administrative data. Controlling for nonresponse selection bias, we used multivariate logit regression analysis to examine the impact of the 5 MU medication elements on the probability of an ADE and on its costs.
Results:
A hospital-acquired ADE was noted in 1.7% of hospitalizations. Odds of an ADE were 63% less in hospitals that adopted all 5 core medication MU elements (10% of hospitals in 2010) compared with hospitals that adopted no core elements. This effect was found even among lowperforming hospitals with below-average Hospital Compare quality. Estimated hospital cost savings per averted ADE were $4790. If all hospitals in Florida had adopted all 5 functions, 55,700 ADEs would have been averted and $267 million per year would have been saved.
Conclusions:
Adoption of core medication MU elements will cut ADE rates, with cost savings that recoup 22% of information technology costs.
Insights
Implementing core medication criteria in meaningful use (MU) significantly reduces hospital-acquired adverse drug events (ADEs) and associated costs. Hospitals adopting all five medication MU elements saw a 63% decrease in ADEs, saving substantial healthcare expenditures.
Area of Science:
- Health Informatics
- Patient Safety
- Health Economics
Background:
- Meaningful Use (MU) requirements heavily emphasize medication management, with over a third of core criteria focused on this area.
- Understanding the impact of these criteria is crucial for optimizing healthcare delivery and patient safety.
Purpose of the Study:
- To assess the influence of five core medication Meaningful Use (MU) criteria on hospital-acquired adverse drug events (ADEs) and their financial implications.
- Establish a baseline for the impact of MU implementation starting in 2011.
Main Methods:
- Utilized the 2010 Florida State Inpatient Database, AHA Healthcare IT Database, and Hospital Compare data.
- Developed novel quality indicators for tracking in-hospital ADEs in administrative data.
- Employed multivariate logit regression, controlling for selection bias, to analyze the effect of medication MU elements on ADE probability and cost.
Main Results:
- Hospital-acquired ADEs occurred in 1.7% of hospitalizations.
- Hospitals adopting all five core medication MU elements (10% in 2010) experienced 63% fewer ADEs compared to those with no adoption.
- Estimated savings of $4790 per averted ADE, with a potential statewide saving of $267 million annually in Florida if all hospitals adopted the criteria.
Conclusions:
- Adoption of core medication MU elements demonstrably reduces ADE rates.
- These improvements lead to significant cost savings, potentially recouping 22% of information technology investments.
- Implementation of medication-related MU criteria enhances patient safety and hospital financial performance.
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