Cost-effectiveness analysis of medical documentation alternatives.
OBJECTIVE
The delay between patient discharge and the completion of the final discharge note have prompted hospitals to consider new information technologies. This study compared the relative cost-effectiveness of an automated medical documentation system to the current system in place at a Canadian hospital. There are significant expenditures associated with the choice of medical documentation system, yet the benefit to the patient population has not been studied.


METHODS
A systematic review of the literature was carried out. Cost data for the current documentation system were obtained from the study hospital. The costs of purchasing the automated system were obtained from the manufacturer. Other resource cost implications of the automated system were estimated based on information obtained from the Centre for Applied Health Informatics at the study hospital. The outcome was determined to be the average time (days) between patient discharge and note completion. A cost-effectiveness analysis was conducted. Sensitivity analyses were used to determine the robustness of the results.


RESULTS
The automated documentation system was associated with higher costs but better outcomes than the current system. The incremental cost-effectiveness ratio used for comparing the automated medical documentation system with the traditional system indicated that the incremental daily cost for decreasing a day in average note completion time per discharge note was 0.331 Canadian $/day over the study period (4 years).


CONCLUSIONS
Although the automated documentation system was more expensive than the current system, it also provided qualitative benefits that were not considered in the cost-effectiveness analysis.
Kopach
Renata
R
Department of Mechanical and Industrial, University of Toronto, Ontario, Canada. kopach@mie.utoronto.ca
Sadat
Somayeh
S
Gallaway
Ian D
ID
Geiger
Glen
G
Ungar
Wendy J
WJ
Coyte
Peter C
PC
D001331:Automation / Q000191:economics*; D003362:Cost-Benefit Analysis; D004282:Documentation / Q000191:economics*; D006801:Humans; D010351:Patient Discharge / Q000191:economics*