Working Paper: NBER ID: w18684
Authors: Jeffery S. McCullough; Stephen Parente; Robert Town
Abstract: Health information technology (IT) adoption, it is argued, will dramatically improve patient care. We study the impact of hospital IT adoption on patient outcomes focusing on the roles of technological and organizational complements in affecting IT's value and explore underlying mechanisms through which IT facilitates the coordination of labor inputs. We link detailed hospital discharge data on all Medicare fee-for-service admissions from 2002-2007 to detailed hospital-level IT adoption information. We employ a difference-in-differences strategy to identify the parameters of interest. For all IT sensitive conditions we find that health IT adoption reduces mortality for the most complex patients but does not affect outcomes for the median patient. This implies that the benefits from IT adoption are skewed to large institutions with a severe case mix. We decompose the impact of health IT into care coordination, clinical information management, and other components. The benefits from health IT are primarily experienced by patients whose diagnoses require cross-specialty care coordination and extensive clinical information management.
Keywords: Health Information Technology; Patient Outcomes; Organizational Complementarities; Informational Complementarities
JEL Codes: D24; I12
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| health IT adoption (I11) | mortality reduction for complex patients (I14) |
| health IT adoption (I11) | no effect on outcomes for median patient (I11) |
| health IT adoption (I11) | mortality reduction for patients requiring extensive clinical information management (I11) |
| health IT adoption (I11) | mortality reduction for pneumonia patients (I14) |
| health IT adoption (I11) | mortality reduction for congestive heart failure patients (I14) |