Association of the Magnitude of Nurses With the Use of Health Information Exchanges: Analyzing the National Health Insurance Claim Data of Hospitals and Clinics in Korea

Abstract

Background Many features of health care organizations (HCOs) have been identified to be associated with health information exchange (HIE), but subcategories of organizational factors focusing on nurse workforces still need to be identified. The objective of this study is to investigate the association of number of nurses with HIE use in Korea. Methods This study had a retrospective study design and used health insurance claim data from June 1, 2016 to June 30, 2018. The unit of analysis was the HCO, and any health insurance claims having HIE were counted by HCO. There were a total of 1490 HCOs having any HIE and 24 026 HCOs not having HIE. For statistical analysis, two-part model was used: logistic regression for HIE participation and the generalized linear model for the volume of HIE use. Results HIE was used by 44.6% of general hospitals, and 8.6% and 5.3% of small hospitals and clinics, respectively. Both HIE use and its volume were significantly positively associated with nurse variables. The use of HIE was significantly positively associated with nurse-to-bed ratio in general hospitals (OR 1.028; 1.016 to 1.041) and in small hospitals (OR 1.021; 1.016 to 1.027), and with the number of nurses (OR 1.041; 1.028 to 1.054) in clinics (P<.001). The volume of HIE use was also positively associated with nurse-to-bed ratio in general hospitals (OR 1.010; 1.004 to 1.017) and in small hospitals (OR 1.014; 1.006 to 1.022), and with the number of nurses (OR 1.055; 1.037 to 1.073) in clinics (P<.01). Conclusion This study found that there was a low rate of HIE use in small hospitals and clinics. The number of nurses was critically associated with the use of HIE and the volume of HIE claims. HIE policy makers need to be aware of this factor in seeking to accelerate HIE.

Quality of Care in Hospitals and the Use of Mobile-Based Personal Health Record Applications: An Exploratory Study Using National Hospital Evaluation Data

“…Nevertheless, there was a statistically significant correlation between the number of m-PHR applications in hospitals and the quality of care regarding antibiotic drug use. The results of this study were similar to those of previous studies, which found that hospitals with active health information exchanges typically had good nursing manpower infrastructure, and hospitals providing high-quality care were more likely to adopt the m-PHR system [ 7 , 20 ]. This suggests that hospitals with excellent infrastructure and high-quality care might be interested in improving customer services, such as adopting and using the m-PHR system.…”

“…M-PHR systems are also known to be effective in chronic disease management [ 16 , 17 , 18 , 19 ]. Healthcare institutions with more health information exchanges tend to have a well-composed medical staff [ 20 ]. In these respects, hospitals that provide high-quality care may have a higher number of m-PHR downloads than others.…”

Findings from the 2022 Yearbook Section on Health Information Exchange

“…They found that satisfaction and attitude were Findings from the 2022 Yearbook Section on Health Information Exchange the only dimensions that predicted continued use. Park et al, looked at structural factors in hospitals that had varying rates of HIE usage in Korea [17]. They found that the extent of HIE use was related to the number of nurses and the nurse-to-bed ratio.…”