title: Association of electronic health records with cost savings in a national sample.
abstract: OBJECTIVE
  To determine whether advanced electronic health record (EHR) use in hospitals is associated with lower cost of providing inpatient care.
  
  
  METHODS
  National Inpatient Sample (NIS) and the Health Information Management Systems Society (HIMSS) Annual Survey are combined in the restrospective, cross-sectional analysis. We study patients who are 18 years or older and discharged from a general acute care hospital.
  
  
  METHODS
  Using 2009 data and a cross-sectional design with a gamma distributed generalized linear model, a patient-level analysis is conducted with propensity scores to control for selection bias. Patient- and organizational-level variables are included as controls. The main outcome measure is total cost per patient admission and represents the amount that it costs the hospital to provide services based on the adjusted charges for an admission.
  
  
  RESULTS
  We include 5,047,089 individuals treated at 550 hospitals in the United States and represent a population-based sample. There are 104 (18.9%) hospitals included that use advanced EHRs. Patients treated in hospitals with advanced EHRs cost, on average, $731, or 9.66%, less than patients admitted to hospitals without advanced EHRs, after controlling for patient and hospital characteristics.
  
  
  CONCLUSIONS
  Hospitals that use advanced EHRs have lower cost per patient admission than comparable hospitals with similar case mix.
authors.affiliation: >Department of Health Care Leadership and Management, Medical University of South Carolina, 151 Rutledge Ave, Charleston, SC 29425. E-mail: swansoaj@ musc.edu.
authors.forename: Abby Swanson
authors.initials: AS
authors.lastname: Kazley
authors.forename: Annie N
authors.initials: AN
authors.lastname: Simpson
authors.forename: Kit N
authors.initials: KN
authors.lastname: Simpson
authors.forename: Ron
authors.initials: R
authors.lastname: Teufel
mesh_terms: D017046:Cost Savings / Q000379:methods / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D057286:Electronic Health Records / Q000191:economics*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D017721:Hospital Costs / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States