Factors impacting the success of computerized preadmission screening.
Many approaches to controlling costs under managed care rely on the ability to prospectively identify the type or level of service a patient requires at the time of presentation. Although computers may effectively predict these factors, the impact of such a computer system is greatly dependent on its integration into the admission process. Three factors that influence the effectiveness of predictive screening using a computer were identified. They are detection, intervention and compliance. The effect of these factors was then measured in a prospective randomized trial evaluating the effectiveness of computerized preadmission screening for predicting the appropriateness of inpatient care. This paper examines the three factors and their impact on the effectiveness of the system. A mathematical model that relates the factors to the overall effectiveness of computerized preadmission screening is proposed and considered in a more general context.
Hales
J W
JW
Division of Medical Informatics, Duke University Medical Center, Durham, NC, USA.
Gardner
R M
RM
Jacobson
J T
JT
D003955:Diagnostic Tests, Routine; D005103:Expert Systems; D006300:Health Services Misuse; D006801:Humans; D010343:Patient Admission / Q000706:statistics & numerical data; D011446:Prospective Studies; D012680:Sensitivity and Specificity