Impact of electronic information exchange on repeat imaging during 30-day readmissions among Medicare beneficiaries

We examined the association between electronic health information sharing and repeat imaging in readmissions among older adults with and without Alzheimer disease (AD). Cohort study using national Medicare data. Among Medicare beneficiaries with 30-day readmissions in 2018, we examined repeat imagin...

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Bibliographic Details
Published in:The American journal of managed care 2024-02, Vol.30 (2), p.66-72
Main Authors: Turbow, Sara D, Culler, Steven D, Vaughan, E Camille, Rask, Kimberly J, Perkins, Molly M, Clevenger, Carolyn K, Ali, Mohammed K
Format: Article
Language:English
Subjects:
Aged
Alzheimer's disease
Beneficiaries
Cohort Studies
Disease
Electronic health records
Health care policy
Hospitalization
Hospitals
Humans
Information sharing
Medicare
Older people
Participation
Patient Readmission
Patients
Retrospective Studies
United States
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Summary:We examined the association between electronic health information sharing and repeat imaging in readmissions among older adults with and without Alzheimer disease (AD). Cohort study using national Medicare data. Among Medicare beneficiaries with 30-day readmissions in 2018, we examined repeat imaging on the same body system during the readmission. This was evaluated between fragmented and nonfragmented (same-hospital) readmissions and across categories of electronic information sharing via health information exchanges (HIEs) in fragmented readmissions: admission and readmission hospitals share the same HIE, admission and readmission hospitals participate in different HIEs, one or both do not participate in HIE, or HIE data missing. This relationship was evaluated using unadjusted and adjusted logistic regression. Overall, 14.3% of beneficiaries experienced repeat imaging during their readmission. Compared with nonfragmented readmissions, fragmented readmissions were associated with 5% higher odds of repeat imaging on the same body system in older adults without AD. This was not mitigated by the presence of electronic information sharing: Fragmented readmissions to hospitals that shared an HIE had 6% higher odds of repeat imaging (adjusted OR, 1.06; 95% CI, 1.00-1.13). There was no difference seen in the odds of repeat imaging for older adults with AD. Despite substantial investment, HIEs as currently deployed and used are not associated with decreased odds of repeat imaging in readmissions.
ISSN:1088-0224
1936-2692
1936-2692
DOI:10.37765/ajmc.2024.89493