title: Managed care penetration and other factors affecting computerized physician order entry in the ambulatory setting.
abstract: OBJECTIVE
  To estimate the current uses level of ambulatory computerized physician order entry (A-CPOE) among physicians and to examine the relationship of managed care penetration as well as other market and practice characteristics to use of A-CPOE by physicians.
  
  
  METHODS
  This study uses both primary and secondary data sources. The primary data source was a large-scale survey of physicians' use of information technologies in Florida. Secondary data on managed care penetration were obtained from the Florida Agency for Health Care Administration, and other market-level data were extracted from the area resource file.
  
  
  METHODS
  A hierarchical logistic regression model was used to examine the correlation of county-level and practice-level characteristics with physicians' self-reported use of A-CPOE systems.
  
  
  RESULTS
  Overall, 1360 physicians (32.4%) indicated use of an A-CPOE system. Findings suggest that 1% more managed care penetration was associated with 2.1% lower use of A-CPOE (P = .003). Additionally, practice size, multispecialty affiliation, and primary care practice were significantly and positively correlated with the use of A-CPOE. Physician age was negatively associated with A-CPOE use.
  
  
  CONCLUSIONS
  Managed care organizations may experience significant financial savings from A-CPOE use by physicians; however, managed care penetration in a community negatively affects A-CPOE use among physicians in their practices. Further study regarding the causal nature of this association is warranted.
authors.affiliation: Department of Family Medicine and Rural Health, Center on Patient Safety, Florida State University College of Medicine, Tallahassee, FL 32306, USA. nir.menachemi@med.fsu.edu
authors.forename: Nir
authors.initials: N
authors.lastname: Menachemi
authors.forename: Eric W
authors.initials: EW
authors.lastname: Ford
authors.forename: Askar
authors.initials: A
authors.lastname: Chukmaitov
authors.forename: Robert G
authors.initials: RG
authors.lastname: Brooks
mesh_terms: D000328:Adult; D003625:Data Collection; D004059:Diffusion of Innovation; D005260:Female; D005431:Florida; D006801:Humans; D008297:Male; D008329:Managed Care Programs; D050316:Medical Order Entry Systems / Q000706:statistics & numerical data*; D008875:Middle Aged; D014481:United States