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Meaningful Use and Hospital Performance on Post-Acute Utilization Indicators.

Yanick N Brice1, Karen E Joynt2, Christopher P Tompkins3

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Summary
This summary is machine-generated.

Meaningful Use (MU) attestation did not improve hospital post-acute care utilization, including readmissions and emergency department visits. Hospitals achieving MU Stage 1 showed no significant gains over non-MU hospitals.

Keywords:
30-day ED utilization30-day readmissionEHRsMeaningful use

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Area of Science:

  • Health Services Research
  • Health Informatics
  • Public Health Policy

Background:

  • Meaningful Use (MU) programs incentivize electronic health record (EHR) adoption.
  • Post-acute care utilization indicators, such as readmission and emergency department (ED) rates, are key measures of hospital quality.
  • The association between MU attestation and improvements in these utilization indicators remains under investigation.

Purpose of the Study:

  • To analyze trends in hospital post-acute utilization indicators between 2009 and 2012.
  • To determine if achieving Meaningful Use (MU) is associated with improved 30-day hospital readmission and ED utilization rates.

Main Methods:

  • Utilized Medicare claims data for 160 short-stay hospitals from 2009-2012.
  • Employed interrupted time series analysis with a concurrent comparison group.
  • Applied propensity score-weighted multilevel models to assess changes in utilization rates.

Main Results:

  • Overall 30-day readmission rates decreased from 13.4% to 12.1%, and ED utilization from 18.9% to 17.3% between 2009 and 2012.
  • Hospitals attesting to Meaningful Use (MU) showed no significant difference in performance improvement compared to non-MU hospitals.
  • MU attestation was unrelated to 30-day readmission rates, and ED utilization unexpectedly deteriorated in MU hospitals.

Conclusions:

  • Meaningful Use (MU) Stage 1 designation did not lead to significant improvements in post-acute utilization indicators.
  • To realize quality gains potentially linked to EHRs, regulators should link MU objectives to comprehensive, outcomes-based performance measures.
  • Strengthening accountability through performance-based measures is crucial for advancing care coordination and patient engagement.