The Relationship Between Pediatric Volume and Information Technology Adoption in Hospitals

Abstract

Numerous studies have identified organizational factors related to the adoption of information technology (IT) by hospitals. However, no study has examined whether patient characteristics of hospitals are related to the adoption of health IT. This study examines IT adoption in hospitals that care for either a large number or a large proportion of children. Primary data from an IT survey of acute care hospitals were combined with secondary data on hospital discharges. Pediatric volume was both categorically and continuously operationalized in several ways. IT adoption was examined both at the individual IT application level and in several aggregate measures of organizational adoption. Univariate and linear regression models were used to analyze the data. Regression models controlled for average patient severity of illness (case mix), public insurance volume, bed size, and system affiliation for each hospital. All 98 acute care hospitals that participated in the survey were matched to the hospital discharge data. Analyses suggest that IT adoption is positively correlated with a higher absolute number of pediatric discharges from hospitals. Similarly, as children make up a higher percentage of a given hospital's discharges, the propensity to adopt clinical and nonclinical IT applications increases significantly as well. Acute care hospitals caring for a large number, or a large proportion, of children are more likely to adopt health IT. This relationship may be because children, when hospitalized, are more likely to seek care in technologically and clinically advanced facilities. However, it is unclear whether the IT adopted is calibrated for optimal pediatric use. More research on the use of IT is needed and should focus on other pediatric clinical settings as well.