Interoperability among hospitals treating populations that have been marginalized

Area of Science:

• Health Informatics
• Health Services Research
• Health Equity

Background:

• Hospital interoperability is essential for seamless health information exchange.
• Socioeconomic factors may influence a hospital's capacity for interoperability.
• Understanding disparities in interoperability is key to addressing health inequities.

Purpose of the Study:

• To investigate the relationship between hospital interoperability and the treatment of economically and socially marginalized populations.
• To assess if hospitals serving areas with high social deprivation exhibit lower levels of interoperable information exchange.
• To examine associations between various marginalization proxies and hospital interoperability.

Main Methods:

• Cross-sectional analysis of 2393 US acute care hospitals using 2021, 2019, and 2019 data.
• Utilized American Hospital Association Information Technology Supplement, Medicare Cost Report, and Social Deprivation Index.
• Assessed relationships between five marginalization proxies and four domains of interoperable information exchange and national network participation.

Main Results:

• Hospitals in high social deprivation areas were 33% less likely to engage in interoperable exchange and 24% less likely to join national networks.
• Critical Access Hospitals (CAH) showed reduced interoperable exchange but similar national network participation.
• Other marginalization measures (Disproportionate Share Hospital percentage, Medicaid case mix) showed no difference, while uncompensated care burden correlated with higher interoperability.

Conclusions:

• Hospitals serving socially deprived populations demonstrate reduced interoperable data exchange.
• Area-based social deprivation is a significant factor associated with lower hospital interoperability.
• Monitoring and addressing these interoperability disparities are vital to mitigate related healthcare disparities.