Author : Sezgin Ayabakan
Publisher :
ISBN 13 :
Total Pages : 248 pages
Book Rating : 4.:/5 (915 download)
Book Synopsis Essays on Healthcare Information Technology and Healthcare Outcomes by : Sezgin Ayabakan
Download or read book Essays on Healthcare Information Technology and Healthcare Outcomes written by Sezgin Ayabakan and published by . This book was released on 2014 with total page 248 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this dissertation, we study the drivers of two important measures of healthcare quality: duplicate tests and readmission. Recent legislation and policy initiatives have targeted to reduce the rate of preventable readmissions for patients with chronic diseases, as well as reduce the amount of waste and redundant expenditures arising from duplicate tests and procedures. Hence, in two separate (but related) empirical studies, we study the determinants of these quality measures and the role of health information technology (HIT) in reducing the level of duplication associated with outpatient imaging tests. In the first essay, we empirically show that congestive heart failure (CHF) patients who switch across hospitals are more likely to exhibit higher rate of duplicating tests compared to patients who are readmitted to the same hospital as their previous visit(s). We attribute the higher duplication rate to the lack of provider access to patient medical history, and find that inter-hospital information sharing technologies significantly reduce the duplicate imaging test rate. Our results demonstrate the value of healthcare information exchanges (HIE) that enable hospitals to lower duplicate testing through better inter-hospital information sharing. In the second essay, we focus on the drivers of readmission rates of CHF patients and observe that hospital readmission rates are determined not only by the quality of care, but also by non-clinical factors such as patient unobserved health status and patient insurance coverage. Our quasi-experimental results indicate that privately insured and self-pay patients experience higher likelihood of readmission after enrolling in Medicare. We also develop and estimate a hidden Markov model (HMM) to study the effect of unobserved health status, with which we reveal its significant impact on patient readmission risk. Overall, our study provides a foundation to better understand the role of health information technology and non-clinical factors and their impact on patient health outcomes. We argue that these factors are likely to influence the success of accountable care organizations (ACOs), which have been promoted as part of the Affordable Care Act (ACA), as a potential solution to curb the runaway growth in healthcare expenditures.