Healthc (Amst) - The effect of health information technology implementation in Veterans Health Administration hospitals on patient outcomes.

Tópicos

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Resumo

CKGROUND: The impact of health information technology (HIT) in hospitals is dependent in large part on how it is used by nurses. This study examines the impact of HIT on the quality of care in hospitals in the Veterans Health Administration (VA), focusing on nurse-sensitive outcomes from 1995 to 2005.METHODS: Data were obtained from VA databases and original data collection. Fixed-effects Poisson regression was used, with the dependent variables measured using the Agency for Healthcare Research and Quality Inpatient Quality Indicators and Patient Safety Indicators software. Dummy variables indicated when each facility began and completed implementation of each type of HIT. Other explanatory variables included hospital volume, patient characteristics, nurse characteristics, and a quadratic time trend.RESULTS: The start of computerized patient record implementation was associated with significantly lower mortality for two diagnoses but significantly higher pressure ulcer rates, and full implementation was associated with significantly more hospital-acquired infections. The start of bar-code medication administration implementation was linked to significantly lower mortality for one diagnosis, but full implementation was not linked to any change in patient outcomes.CONCLUSIONS: The commencement of HIT implementation had mixed effects on patient outcomes, and the completion of implementation had little or no effect on outcomes.IMPLICATIONS: This longitudinal study provides little support for the perception of VA staff and leaders that HIT has improved mortality rates or nurse-sensitive patient outcomes. Future research should examine patient outcomes associated with specific care processes affected by HIT.

Resumo Limpo

ckground impact health inform technolog hit hospit depend larg part use nurs studi examin impact hit qualiti care hospit veteran health administr va focus nursesensit outcom method data obtain va databas origin data collect fixedeffect poisson regress use depend variabl measur use agenc healthcar research qualiti inpati qualiti indic patient safeti indic softwar dummi variabl indic facil began complet implement type hit explanatori variabl includ hospit volum patient characterist nurs characterist quadrat time trendresult start computer patient record implement associ signific lower mortal two diagnos signific higher pressur ulcer rate full implement associ signific hospitalacquir infect start barcod medic administr implement link signific lower mortal one diagnosi full implement link chang patient outcomesconclus commenc hit implement mix effect patient outcom complet implement littl effect outcomesimpl longitudin studi provid littl support percept va staff leader hit improv mortal rate nursesensit patient outcom futur research examin patient outcom associ specif care process affect hit

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