JMIR Publications

ABSTRACT

Background:

Although rapid expansion of electronic health information sharing is occurring nationally, it is unclear whether health information sharing improves patient outcomes, particularly for patients who are at highest risk of communication challenges, such as older adults with Alzheimer’s disease (AD). 

Objective:

To determine the association between electronic information exchange and in-hospital and post-discharge mortality among Medicare beneficiaries with Alzheimer’s Disease with 30-day readmissions following admissions for common conditions

Methods:

Among Medicare beneficiaries with Alzheimer’s disease who had one or more 30-day readmissions in 2018 following hospital admissions for select conditions, we examined the association between electronic information sharing and in-hospital mortality during the readmission or mortality in the 30 days following readmission.  

Results:

28,946 admission-readmission pairs were included. Compared to admissions and readmissions to the same hospital, beneficiaries who had a readmission to a different hospital that shared an HIE with the admission hospital had 39% lower odds of dying during the readmission (AOR 0.61, 95% CI 0.39, 0.95). There were no differences in in-hospital mortality observed for admission-readmission pairs to different hospitals that participated in different HIEs (AOR 1.02, 95% CI 0.82, 1.28) or to different hospitals where one or both hospitals did not participate in HIE (AOR 1.25, 95% CI 0.93, 1.68), and there was no association between information sharing and post-discharge mortality.  

Conclusions:

These results indicate that information sharing between unrelated hospitals may be associated with lower in-hospital, but not post-discharge, mortality for older adults with AD, a potentially vulnerable group.