Health information exchange systems and length of stay in readmissions to a different hospital

Natalie Flaks-Manov, Efrat Shadmi, Moshe Hoshen, Ran D. Balicer

نتاج البحث: نشر في مجلةمقالةمراجعة النظراء

ملخص

BACKGROUND: Readmission to a different hospital than the original discharge hospital may result in breakdowns in continuity of care. In different-hospital readmissions (DHRs), continuity can be maintained when hospitals are connected through health information exchange (HIE) systems. OBJECTIVE: To examine whether length of readmission stay (LORS) differs between same-hospital readmissions and DHRs, and whether in DHRs the LORS differs by the availability of HIE. DESIGN: A retrospective cohort study of all internal medicine 30-day readmissions in 27 Israeli hospitals between January 1, 2010 and December 31, 2010. SETTING: Clalit Health Services-Israel's largest integrated healthcare provider and payer. POPULATION: Adult Clalit members (aged 18 and older) with at least 1 readmission during the study period. METHODS: A multivariate marginal Cox model tested the likelihood for discharge during each readmission day in same-hospital readmissions (SHRs), DHRs with HIE, and DHRs without HIE. RESULTS: Of the 27,057 readmissions, 3130 (11.6%) were DHRs and 792 where DHRs with HIE in both the index and readmitting hospital. Partial continuity (DHRs with HIE) was associated with decreased likelihood of discharge on any given day compared with full continuity (SHRs) (hazard ratio [HR] = 0.85, 95% confidence interval [CI]: 0.79-0.91). Similar results were obtained for no continuity (DHRs without HIE) versus full continuity (HR = 0.90, 95% CI: 0.86-0.94). The difference between DHRs with and without HIE was not significant. CONCLUSIONS: The prolonged LORS in DHRs versus SHRs was not mitigated by the existence of HIE systems. Future research is needed to further elucidate the effects of actual use of HIE on length of DHRs.

اللغة الأصليةإنجليزيّة أمريكيّة
الصفحات (من إلى)401-406
عدد الصفحات6
دوريةJournal of Hospital Medicine
مستوى الصوت11
رقم الإصدار6
المعرِّفات الرقمية للأشياء
حالة النشرنُشِر - 1 يونيو 2016

All Science Journal Classification (ASJC) codes

  • !!Fundamentals and skills
  • !!Care Planning
  • !!Assessment and Diagnosis
  • !!Health Policy
  • !!Leadership and Management
  • !!Internal Medicine

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