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The adoption of hospital information systems


  • Jeffrey S. McCullough

    (Division of Health Policy & Management, University of Minnesota, Minneapolis, MN, USA)


This paper empirically examines the diffusion of hospital information systems (ISs), specifically, pharmacy, laboratory, and radiology systems. Given the policy significance of health IS and the widespread perception that it's diffusion is slow, a better understanding of the mechanisms driving IS adoption is needed. A novel data set incorporating both IS adoption and hospital characteristics was constructed. These data follow the behavior of 1965 hospitals for the years 1990-2000. Hypotheses pertaining to hospital characteristics, hospital competition, and strategic behavior are tested utilizing proportional hazard models. I find that IS adoption is related to multi-hospital system membership, payer mix, and hospital scale. The role of scale, however, significantly diminishes throughout the time period, likely reflecting improved personal computer performance and improved IT scalability. Conversely, I find little that strategic behavior or hospital competition affects IS adoption. Likewise, hospital ownership does not affect the adoption of these systems. Overall, these results suggest that hospital IS diffusion has not been normatively slow. Copyright © 2007 John Wiley & Sons, Ltd.

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  • Jeffrey S. McCullough, 2008. "The adoption of hospital information systems," Health Economics, John Wiley & Sons, Ltd., vol. 17(5), pages 649-664.
  • Handle: RePEc:wly:hlthec:v:17:y:2008:i:5:p:649-664 DOI: 10.1002/hec.1283

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    References listed on IDEAS

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    Cited by:

    1. Borzekowski, Ron, 2009. "Measuring the cost impact of hospital information systems: 1987-1994," Journal of Health Economics, Elsevier, vol. 28(5), pages 938-949, September.
    2. Fareed, Naleef & Bazzoli, Gloria J. & Farnsworth Mick, Stephen S. & Harless, David W., 2015. "The influence of institutional pressures on hospital electronic health record presence," Social Science & Medicine, Elsevier, vol. 133(C), pages 28-35.
    3. repec:spr:infosf:v:16:y:2014:i:4:d:10.1007_s10796-012-9361-1 is not listed on IDEAS
    4. David Dranove & Chris Forman & Avi Goldfarb & Shane Greenstein, 2014. "The Trillion Dollar Conundrum: Complementarities and Health Information Technology," American Economic Journal: Economic Policy, American Economic Association, vol. 6(4), pages 239-270, November.
    5. McCullough, Jeffrey S. & Snir, Eli M., 2010. "Monitoring technology and firm boundaries: Physician-hospital integration and technology utilization," Journal of Health Economics, Elsevier, vol. 29(3), pages 457-467, May.
    6. Laurence C. Baker & Kate Bundorf & Daniel Kessler, 2014. "Expanding Patients' Property Rights In Their Medical Records," NBER Working Papers 20565, National Bureau of Economic Research, Inc.
    7. repec:kap:atlecj:v:45:y:2017:i:4:d:10.1007_s11293-017-9557-3 is not listed on IDEAS
    8. Natalia Zhivan & Mark Diana, 2012. "U.S. hospital efficiency and adoption of health information technology," Health Care Management Science, Springer, vol. 15(1), pages 37-47, March.
    9. Spyros Arvanitis & Euripidis N. Loukis, 2016. "Investigating the effects of ICT on innovation and performance of European hospitals: an exploratory study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(4), pages 403-418, May.
    10. Bourke, Jane & Roper, Stephen, 2014. "The influence of experiential learning on medical equipment adoption in general practices," Health Policy, Elsevier, vol. 118(1), pages 37-47.
    11. repec:spr:soinre:v:134:y:2017:i:3:d:10.1007_s11205-016-1454-7 is not listed on IDEAS

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