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American Academy of Pediatrics
Research Articles

Lower Rates of EMR Use in Rural Hospitals Represent a Previously Unexplored Child Health Disparity

Annie Lintzenich Andrews, Abby Swanson Kazley, William T. Basco and Ronald J. Teufel
Hospital Pediatrics July 2014, 4 (4) 211-216; DOI: https://doi.org/10.1542/hpeds.2013-0115
Annie Lintzenich Andrews
1Departments of Pediatrics, and
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Abby Swanson Kazley
2Healthcare Leadership and Management, Medical University of South Carolina, Charleston, South Carolina
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William T. Basco Jr
1Departments of Pediatrics, and
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Ronald J. Teufel II
1Departments of Pediatrics, and
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Abstract

Objectives: Rural hospitals face significant barriers to adoption of advanced-stage electronic medical records (EMRs), which may translate to an unexplored disparity for children in rural hospitals. Our objective was to determine whether children hospitalized in rural settings are less likely to be cared for using advanced-stage EMRs.

Methods: We merged the 2009 Healthcare Cost and Utilization Project Kids Inpatient Dataset with the 2009 Healthcare Information and Management Systems Society database. Logistic regression determined the independent relationship between receiving care in a rural hospital and advanced-stage EMRs.

Results: A total of 430 055 (9.3%) of the 4 605 454 pediatric discharges were rural. Logistic regression analysis determined that even when an extensive list of various patient and hospital characteristics are accounted for, rurality continues to be a strong predictor of a child’s care without advanced-stage EMRs (odds ratio 0.3; 95% confidence interval, 0.2–0.5).

Conclusions: Children hospitalized in a rural hospital are less than half as likely to be treated using advanced-stage EMRs. A focus of government and hospital policies to expand the use of EMRs among rural hospitals may reduce this child health care disparity.

  • electronic medical records
  • rural hospitals
  • and disparity
  • Abbreviations:
    APR-DRG
    All Patient Refined Diagnosis Related Groups
    EMR
    electronic medical record
    HITECH
    Healthcare Information Technology for Economic and Clinical Health
    HCUP KID
    Healthcare Cost and Utilization Project Kids Inpatient Dataset
    HIMSS
    Healthcare Information and Management Systems Society
    • Copyright © 2014 by the American Academy of Pediatrics
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    Hospital Pediatrics: 4 (4)
    Hospital Pediatrics
    Vol. 4, Issue 4
    1 Jul 2014
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    Lower Rates of EMR Use in Rural Hospitals Represent a Previously Unexplored Child Health Disparity
    Annie Lintzenich Andrews, Abby Swanson Kazley, William T. Basco, Ronald J. Teufel
    Hospital Pediatrics Jul 2014, 4 (4) 211-216; DOI: 10.1542/hpeds.2013-0115

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    Lower Rates of EMR Use in Rural Hospitals Represent a Previously Unexplored Child Health Disparity
    Annie Lintzenich Andrews, Abby Swanson Kazley, William T. Basco, Ronald J. Teufel
    Hospital Pediatrics Jul 2014, 4 (4) 211-216; DOI: 10.1542/hpeds.2013-0115
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