%0期刊文章%@ 2561- 7605% I JMIR出版物%V 5%卡塔尔世界杯8强波胆分析 N 3% P e37482% T检查美国养老院的结构差异:全美健康信息技术成熟度调查%A Alexander,Gregory L %A Liu,Jianfang %A Powell,Kimberly R %A Stone,Patricia W %+哥伦比亚大学护理学院，美国纽约州，10032，纽约168街560 W 628室，1 573 301 3131，ga2545@cumc.columbia.edu %K养老院%K健康信息技术%K政策%K护理信息%K电子健康记录%K电子数据%K数据共享%K护理提供者%K居民%K护理%K护理质量%K结构差异%K临床支持%K管理%D 2022 %7 23.8.2022 %9原始论文%J JMIR老龄化%G英语%X背景:美国有15,632家养老院(NHs)。国民保健制度继续受到重大的政策关注，由于高成本和护理效果差。改善国家卫生保健的一个策略是使用卫生信息技术(HIT)。本研究的核心概念是HIT成熟度，用于确定HIT功能的采用趋势，在住院护理、临床支持和管理活动中的使用和集成。这一概念是由诺兰阶段理论(Nolan stage theory)指导的，该理论假设HIT等系统会经历一系列可测量的阶段。HIT的成熟是迅速变化的nhh景观的一个重要组成部分，这正在受到保护居民的政策的影响，部分原因是大流行。目的:本研究的目的是确定NH HIT成熟度的结构差异，并观察其是否被常用的组织特征所调节。方法:使用疗养院比较数据从每个州随机招募NHs (n=6123， >20%)。 Investigators used a validated HIT maturity survey with 9 subscales including HIT capabilities, extent of HIT use, and degree of HIT integration in resident care, clinical support, and administrative activities. Each subscale had a possible HIT maturity score of 0-100. Total HIT maturity, with a possible score of 0-900, was calculated using the 9 subscales (3 x 3 matrix). Total HIT maturity scores equate 1 of 7 HIT maturity stages (stages 0-6) for each facility. Dependent variables included HIT maturity scores. We included 5 independent variables (ie, ownership, chain status, location, number of beds, and occupancy rates). Unadjusted and adjusted cumulative odds ratios were calculated using regression models. Results: Our sample (n=719) had a larger proportion of smaller facilities and a smaller proportion of larger facilities than the national nursing home population. Integrated clinical support technology had the lowest HIT maturity score compared to resident care HIT capabilities. The majority (n=486, 60.7%) of NHs report stage 3 or lower with limited capabilities to communicate about care delivery outside their facility. Larger NHs in metropolitan areas had higher odds of HIT maturity. The number of certified beds and NH location were significantly associated with HIT maturity stage while ownership, chain status, and occupancy rate were not. Conclusions: NH structural disparities were recognized through differences in HIT maturity stage. Structural disparities in this sample appear most evident in HIT maturity, measuring integration of clinical support technologies for laboratory, pharmacy, and radiology services. Ongoing assessments of NH structural disparities is crucial given 1.35 million Americans receive care in these facilities annually. Leaders must be willing to promote equal opportunities across the spectrum of health care services to incentivize and enhance HIT adoption to balance structural disparities and improve resident outcomes. %M 35998030 %R 10.2196/37482 %U https://aging.www.mybigtv.com/2022/3/e37482 %U https://doi.org/10.2196/37482 %U http://www.ncbi.nlm.nih.gov/pubmed/35998030