title: Differences in pneumonia treatment between high-minority and low-minority neighborhoods with clinical decision support system implementation.
abstract: BACKGROUND
  The relationship between clinical decision support systems (CDSS) and quality is a relatively new, and in light of the new health information technology (HIT) legislation, policy-relevant area. Moreover, very few studies exist examining the link between HIT and healthcare disparities. The purpose of this article is to examine the association between CDSS and the treatment of pneumonia care within high-minority (≥29.1% non-White, non-Hispanic) and low-minority (<29.1%) Zip Code Tabulation Areas (ZCTAs).
  
  
  METHODS
  This study employed a cross-sectional design and used 2009 data from the American Hospital Association, the Centers for Medicare and Medicaid Services and the Research Triangle Institute. Adjusted analysis controlled for a hospital's propensity to use CDSS.
  
  
  RESULTS
  In the unadjusted analysis, hospitals in high-minority ZCTAs had lower pneumonia quality composite scores than their low-minority counterparts. When adjusting for other hospital and ZCTA-level variables, we found that CDSS use had stronger positive associations with quality in high-minority hospitals.
  
  
  CONCLUSIONS
  Results support policy directives may support higher quality improvements by focusing CDSS adoption in high-minority hospitals.
authors.affiliation: a Department of Healthcare Administration , University of Houston Clear Lake , Houston , TX , USA .
authors.forename: Jordan
authors.initials: J
authors.lastname: Mitchell
authors.affiliation: b Department of Health Services Policy and Management , University of South Carolina , Columbia , SC , USA .
authors.forename: Janice C
authors.initials: JC
authors.lastname: Probst
authors.affiliation: c Department of Family and Preventive Medicine .
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Bennett
authors.affiliation: d Institute for Partnerships to Eliminate Health Disparities .
authors.forename: Saundra
authors.initials: S
authors.lastname: Glover
authors.affiliation: e Department of Stomatology , University of South Carolina , Columbia , SC , USA , and.
authors.forename: Amy Brock
authors.initials: AB
authors.lastname: Martin
authors.affiliation: f Edwards College of Medicine, Medical University of South Carolina , Charleston , SC , USA.
authors.forename: James W
authors.initials: JW
authors.lastname: Hardin
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D020000:Decision Support Systems, Clinical; D054625:Healthcare Disparities; D006801:Humans; D008913:Minority Groups; D011014:Pneumonia / Q000188:drug therapy*; D011787:Quality of Health Care; D014481:United States
keywords: Clinical decision support systems; disparities; pneumonia; quality