The Trillion Dollar Conundrum: Complementarities and Health Information Technology
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چکیده
We examine the heterogeneous relationship between the adoption of electronic medical records (EMR) and hospital operating costs at thousands of U.S. hospitals between 1996 and 2009. Combining data from multiple sources, we first identify a puzzle that has been seen in prior studies: Adoption of EMR is generally associated with a slight increase in costs. We draw on the literature on information technology and productivity to analyze why this average effect arises, and explain why it masks important differences over time, across locations, and across hospitals. We find evidence consistent with this approach, namely, that: (1) EMR adoption is initially associated with a rise in costs; (2) EMR adoption at hospitals in favorable conditions – such as urban locations – leads to a decrease in costs after three years; and (3) Hospitals in unfavorable conditions experience a sharp increase in costs even after six years. JEL Code: I10, L30, O33 Corresponding author: Avi Goldfarb, Rotman School of Management, University of Toronto, 105 St George St, Toronto ON, M5S 3E6, CANADA, phone 416-946-8604, fax 416-978-5433, [email protected]. We thank BingYang Li for excellent research assistance. We thank seminar participants at Georgia Tech, Harvard Business School, MIT, the University of Arizona, the University of Georgia, the University of Helsinki, and the University of Zurich for helpful comments, and we thank Dr. David Artz, Tim Simcoe, and Leemore Dafny for useful comments and suggestions. We also thank Harte Hanks Market Intelligence for supplying data. Avi Goldfarb thanks SSHRC for research support. We are responsible for all opinions and errors.
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تاریخ انتشار 2012