Feliciano Yu1, Thomas K Houston. 1. University of Alabama at Birmingham Center for Effectiveness Research and Evaluation, USA. Fyu@peds.uab.edu
Abstract
BACKGROUND: A study was conducted in 2006 to compare differences in objective quality of care measures among hospitals labeled "Most Wired"--a hospital or member-hospital of a health system listed among the Hospital and Health Network's Healthcare's Most Wired Hospitals for 2004--versus hospitals without that designation. METHODS: Ten quality indicators representing cardiac and pulmonary measures were calculated for adult hospitals participating in the U.S. Department of Health and Human Services' Hospital Compare initiative. Performance of Most Wired hospitals and comparison hospitals was compared using t-tests. The association of the Most Wired designation to measures of care was assessed using multivariable linear regression and generalized estimating equations. RESULTS: Compared with comparison hospitals, Most Wired hospitals tend to be larger, not-for profit and teaching hospitals. Most Wired hospitals outperformed comparison hospitals in all but one quality indicator (p < .05). After adjustment, Most Wired hospitals were independently associated with better quality scores for only 2 out of 10 quality indicators. The Most Wired hospitals did not significantly underperform for any indicator. CONCLUSION: Most Wired hospitals outperformed other hospitals on most objective quality of care measures. However, some of the results were significantly attenuated by other factors associated with quality, suggesting that for specific indicators, "Most Wired" may be a marker of overall quality more than an independent factor. More research is needed on how overall implementation of health information technology directly affects quality of care measures.
BACKGROUND: A study was conducted in 2006 to compare differences in objective quality of care measures among hospitals labeled "Most Wired"--a hospital or member-hospital of a health system listed among the Hospital and Health Network's Healthcare's Most Wired Hospitals for 2004--versus hospitals without that designation. METHODS: Ten quality indicators representing cardiac and pulmonary measures were calculated for adult hospitals participating in the U.S. Department of Health and Human Services' Hospital Compare initiative. Performance of Most Wired hospitals and comparison hospitals was compared using t-tests. The association of the Most Wired designation to measures of care was assessed using multivariable linear regression and generalized estimating equations. RESULTS: Compared with comparison hospitals, Most Wired hospitals tend to be larger, not-for profit and teaching hospitals. Most Wired hospitals outperformed comparison hospitals in all but one quality indicator (p < .05). After adjustment, Most Wired hospitals were independently associated with better quality scores for only 2 out of 10 quality indicators. The Most Wired hospitals did not significantly underperform for any indicator. CONCLUSION: Most Wired hospitals outperformed other hospitals on most objective quality of care measures. However, some of the results were significantly attenuated by other factors associated with quality, suggesting that for specific indicators, "Most Wired" may be a marker of overall quality more than an independent factor. More research is needed on how overall implementation of health information technology directly affects quality of care measures.