From: A systematic review of the cost of data collection for performance monitoring in hospitals
Study | Intervention and control | Objective and type of study | Setting, population, and perspective | Costs | Benefits | Results and conclusions |
---|---|---|---|---|---|---|
Holloway et al. [6] | Intervention: computerised electronic records systems, PAS-MAP | Compare differences in completeness, timeliness, operability, and cost | Setting: 214-bed general hospital was studied | Differences in costs of PAS-MAP and manual system including: data abstraction costs, subscriptions, and summary preparation time | Completeness | Costs: the manual system would cost $2,593 more per year than the PAS |
Comparator: manual system, hand written records | Type of study: cost analysis | Three departments: general practice, medicine, and surgery | Timeliness | Manual system more complete, as timely, and more likely to prevent human error | ||
Population: physicians, medical admin staff | Operability | |||||
Perspective: not stated | ||||||
Klimt et al. [7] | Intervention: Dictaphone for transcribing records | Compare the costs and benefits of transcribing technology against the manual system | Setting: Emergency Department | Cost of average length of record, true transcriber cost (including salary cost, bonus), true productivity of transcriber. Equipment costs are reported | Completeness | Incremental cost of typing an emergency record is $1.03 |
Comparator: manual system | Type of study: cost minimisation analysis | Population: physicians and surgeons | Timeliness | Transcribed medical records more complete, less timely, and more accurate | ||
Perspective: not stated | Operability | |||||
Accuracy of billings | ||||||
Tierney et al. [8] USA (Indiana) | Intervention: computerised inpatient orders | To assess the effects on healthcare resource utilisation of a network of microcomputer workstations for writing all inpatient orders | Setting: inpatient internal medicine service hospital | Total costs which include: bed costs, test costs, drug costs, and other costs. Equipment and installation costs are reported | Total charges | Total costs with workstations: $594 less (10.5% lower bed costs, 12.4% lower tests costs, 15.1% lower drug costs) |
Comparator: normal practice | Type of study: cost- consequence analysis | Population: inpatients, house officers, medical students, and faculty internists | Hospital length of stay | Hospital length of stay declined by 0.89 days | ||
Perspective: not stated | Benefits speculated | |||||
Philp et al. [9] UK | Intervention: Information system for monitoring impact of acute hospital care on health status | Develop a patient information system which could be used to evaluate the effectiveness of multidisciplinary hospital care | Setting: Hospital | Staff time, printing, statistical analysis, computing equipment and system administration. | Nurse perspective: | Total annual cost per ward £6,455 to incorporate follow-up assessments |
Comparator: normal practice | Type of study: cost analysis | Population: physicians, nurses, and junior physicians | Decision-making | Undecided if decision-making, teamwork, professional care, and performance was improved | ||
Perspective: not stated | Teamwork | Benefits for patient care can only be inferred, not proven | ||||
Professional care | ||||||
Performance | ||||||
Willems et al. [10] Belgium | Intervention: follow-up programme that informs physicians of their compliance and outlines the financial consequences of using prophylactic antibiotics | Evaluate the follow-up programme | Setting: post-operative surgery and obstetrics care | Cost of antibiotic use | Benefits speculated | Total cost of antibiotic use reduced by 50% |
Comparator: previous practice | Type of study: cost analysis | Population: physicians | An average loss of €92,353 pre-intervention became profit average of €27,269 post-intervention | |||
Perspective: hospital | ||||||
Barnes et al. [13] USA (Ohio) | Standardisation of coding | Compare volumes, length of stay, and billings volume before and after implementation intervention | Setting: Trauma Care and Surgery Department | Costs are not reported | Hospital length of stay | Increase of $270.46 (394%) on average SHC revenue per trauma service admission |
Comparator: no standardisation | Type of study: not clear | Population: physicians | Completeness | More consistent and complete documentation of patient care. | ||
Perspective: not stated | Accuracy of billings | |||||
Encinosa and Bae [11] | Intervention: Basic Electronic Medical Records (EMRs) | Assess whether EMRs prevent hospital-acquired conditions (HACs), death, readmissions, and high spending | Setting: inpatient and outpatient departments | Average cost of patient safety event | Probability of death and readmission | Excess spending on patient safety events declines by $4,849 or 16% due to basic EMRs |
Comparator: no basic EMRs | Type of study: cost effectiveness analysis | Population: physicians and patients | IT capital and operation costs | EMRs had no impact on the probability of a patient safety event occurring | ||
Perspective: not stated | EMRs reduce the probability of readmission once a patient safety event occurs | |||||
Encinosa and Bae et al. [12] | Intervention: quality indicator based on five core MU elements | Compare the costs and effects of using up to five elements within a quality indicator | Setting: inpatient departments | All hospital costs were included except physician and laboratory costs (no justification as to why these were left out and no table to describe what costs were included) | Averted adverse drug event | Estimated costs savings at $4,790 per averted adverse drug event |
Comparator: use of 0 to 5 elements | Type of study: cost effectiveness analysis | Population: patients and physicians | Adoption of core MU elements can reduce ADEs, with cost savings that recoup 22% of IT costs | |||
Perspective: not stated |