医院对之间的电子连接:对急诊室相关利用的影响
Julia Adler-Milstein1, Ariel Linden1, Renee Y Hsia2
1Division of Clinical Informatics and Digital Transformation, Department of Medicine, University of California, San Francisco, San Francisco, CA 94131, United States.
Journal of the American Medical Informatics Association : JAMIA
|November 18, 2025
概括
卫生信息交换 (HIE) 并没有持续降低急诊室 (ED) 的利用率. 虽然返回同一家医院减少了一些ED使用,但HIE对不同机构之间的护理协调的影响有限.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 医疗信息学 医疗信息学
- 公共卫生 公共卫生
背景情况:
- 紧急部门 (ED) 的利用是医疗保健成本的重要组成部分.
- 假设有效的健康信息交换 (HIE) 可以改善护理协调,减少多余的服务.
- 精确测量医院连接对于评估HIE的影响至关重要.
研究的目的:
- 精确测量医院电子连接,并评估健康信息交换 (HIE) 和急诊室 (ED) 使用之间的关联.
- 为了确定HIE是否影响重复成像,治疗和释放ED访问后入院,或出院后入院.
主要方法:
- 利用2018年医疗保险服务费索赔,在30天内识别两个ED遭遇的受益人.
- 将索赔数据与 Definitive Healthcare 和 AHA IT 补充数据结合起来,以确定医院参与 HIE 网络.
- 分析了结果,包括重复成像,治疗和释放ED访问后的入院,以及在同一或不同的组织 (HIE连接或不连接) 遭遇医院出院后的入院.
主要成果:
- 与访问不同组织的受益者相比,返回同一组织的受益者在治疗和释放ED访问后重复成像和入院的利用率明显较低.
- 回到同一个组织与医院出院后入院的利用率更高有关.
- 在比较不同组织时,健康信息交换 (HIE) 与重复成像或出院后入院的可能性较低无关.
- HIE与治疗和释放ED访问 (1.83个百分点) 后入院的可能性较低有关.
结论:
- 回到同一个医疗保健组织可能会改善信息获取,或反映其他因素,如对齐的激励措施,导致不同的使用模式.
- 卫生信息交换 (HIE) 似乎并没有连续地与改善的利用结果相关联,这表明在急诊部 (ED) 设置中的协调护理.
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