Determinants of hospital information system (HIS) integrity and hospital performance.

摘要

The two dominant issues in the health care industry are health care cost and quality. Health care cost has been escalating for the last twenty years. Great pressure has been put on hospitals to cut costs. Since hospital information systems (HIS) were introduced into hospital management, they have been expected to improve patient care as well as hospital management. However, the relationship between HIS integrity and hospital performance has been unclear.; HIS integrity, measured by structure functionality, connectivity, and executive decision functionality, is empirically examined in this study. Structural functionality means the ability of the system to automate organizational tasks, or the completeness of the basic HIS applications. Connectivity means the ability of the information system to facilitate communication or coordination among organizational elements. Executive decision support functionality means the ability of an information system to retrieve, manipulate, and display information from integrated databases for making specific managerial decisions. Using short-term, acute care hospitals as the unit of analysis, the aim of this study is to identify the environmental and organizational factors affecting HIS integrity, and to examine the relationship between HIS integrity and hospital performance.; This study examined the information systems of more than 2000 short-term, acute care hospitals. The results of this study provide empirical evidence to support the adoption of HIS. As shown in this study, the majority of hospitals had some kinds of HIS applications in 1999. Multivariate analysis indicates that there are three factors that hospital administrators have to consider when deciding about arrangements for providing HIS. These factors are the size of the hospital, integrated delivery system (IDS) affiliation, and the number of hi-tech services.; The findings suggest that the studied hospitals have relatively higher levels of structural functionality and connectivity; however, their decision support functionality is low. It is important for top executives to know that there is variation in HIS integrity, especially in decision support functionality. Many hospitals, faced with demands for improved information system functionality, jump to the conclusion that their existing systems are inadequate and that purchasing a new system is the only way to address their needs. This study argues that hospitals should find ways to make the best use of existing resources and focus on the development of a high level of decision support functionality.; The study also found that HIS integrity is associated with performance. A high level of HIS integrity is significantly related to shorter average length of stay and lower average cost. These findings provide further support for the investment in HIS. The HIS integrity construct is useful as a conceptual framework that can guide top executives in designing new his or evaluating an existing HIS.