Impact of health care information technology on hospital productivity growth: a survey in 17 acute university hospitals.

The quantification of the added value of information technologies (IT) in the health sector is a major issue for decision-makers and health care professionals. This paper relates the application of an economic production function in hospitals with different integration levels of their clinical information systems (CIS). The study concerns 17 university hospitals within the Assistance Publique Hôpitaux de Paris group that were followed from 1998 to 2005. Using an extended Cobb-Douglas production function, yearly incomes (Y) were correlated with three inputs: capital (K), labor (L) and IT expenses (T). The results indicate that incomes are significantly and positively associated with the three input variables with elasticity coefficients: alpha, beta and gamma of 0.81, 0.17, and 0.09 that appear to be in the range of values found in secondary and tertiary sectors. The IT elasticity coefficient (gamma) is higher in the subgroup of 6 hospitals that integrate, or started to integrate, a complete CIS within the study period than in the 11 reference hospitals. In a general production function, hospital costs appear to be positively connected to the level of IT expenses, capital and labor. Calculations in two subgroups of AP-HP hospitals divided according to the importance of the IT integration level seem to indicate that the more the clinical information system is integrated, the more its influence is positive in hospital production. The results of this first survey are sufficiently encouraging to try to refine them (better granularity) and to spread them in time (over a longer period) and space (to other hospital structures).