title: Health information exchange and healthcare utilization.
abstract: Health information exchange (HIE) makes previously inaccessible data available to clinicians, resulting in more complete information. This study tested the hypotheses that HIE information access reduced emergency room visits and inpatient hospitalizations for ambulatory care sensitive conditions among medically indigent adults. HIE access was quantified by how frequently system users' accessed patients' data. Encounter counts were modeled using zero inflated binomial regression. HIE was not accessed for 43% of individuals. Patient factors associated with accessed data included: prior utilization, chronic conditions, and age. Higher levels of information access were significantly associated with increased counts of all encounter types. Results indicate system users were more likely to access HIE for patients for whom the information might be considered most beneficial. Ultimately, these results imply that HIE information access did not transform care in the ways many would expect. Expectations in utilization reductions, however logical, may have to be reevaluated or postponed.
authors.affiliation: School of Rural Public Health, Texas A&M Health Science Center, College Station, TX, USA. jrvest@srph.tamhsc.edu
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Vest
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002908:Chronic Disease; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008489:Medical Indigency / Q000706:statistics & numerical data*; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D008875:Middle Aged; D044469:Racial Groups; D012737:Sex Factors; D055815:Young Adult