Table 4.
Main Analysis of One-Group Pre- and Post-EHR Logistic Regression and Difference-in-Differences Estimation for Specific Surgical Care Improvement Project (SCIP) Measures†
| One-Group Pre- and Post-EHR Logistic Regression | Difference-in-Differences Estimation | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Unadjusted | Adjusted | Unadjusted | Adjusted | |||||||||
| Measure | OR | LCL | UCL | OR | LCL | UCL | OR | LCL | UCL | OR | LCL | UCL |
| Composite‡ | ||||||||||||
| Mar-11 | 0.46* | 0.21 | 1.00 | 0.49* | 0.22 | 1.08 | 0.09 | 0.00 | 1.62 | 0.09* | 0.01 | 1.48 |
| Apr-11 | 0.46** | 0.22 | 0.96 | 0.45** | 0.22 | 0.95 | 0.85 | 0.24 | 2.99 | 0.97 | 0.27 | 3.43 |
| May-11 | 1.01 | 0.40 | 2.59 | 1.10 | 0.44 | 2.72 | 2.76 | 0.74 | 10.27 | 3.49* | 0.95 | 12.85 |
| Jun-11 | 1.33 | 0.24 | 7.20 | 1.11 | 0.22 | 5.45 | 2.28 | 0.20 | 26.11 | 2.93 | 0.27 | 31.43 |
| SCIP-Inf-4§ | ||||||||||||
| Mar-11 | 0.30** | 0.10 | 0.91 | 0.45 | 0.13 | 1.56 | Not applicable‡‡ | Not applicable‡‡ | ||||
| Apr-11 | 0.49 | 0.13 | 1.86 | 0.55 | 0.13 | 2.33 | ||||||
| May-11 | 1.51 | 0.25 | 9.17 | 2.01 | 0.32 | 12.49 | ||||||
| Jun-11 | 1.62 | 0.08 | 32.81 | 2.19 | 0.11 | 45.35 | ||||||
| SCIP-Inf-9¶ | ||||||||||||
| Mar-11 | 0.94 | 0.16 | 5.56 | 1.58 | 0.14 | 18.25 | 0.22 | 0.01 | 6.60 | 0.76 | 0.02 | 34.32 |
| Apr-11 | 0.25** | 0.09 | 0.73 | 0.21** | 0.07 | 0.66 | 0.07* | 0.00 | 1.42 | 0.03* | 0.00 | 1.08 |
| May-11 | 1.23 | 0.21 | 7.23 | 1.58 | 0.21 | 12.13 | 3.75 | 0.47 | 30.21 | 12.96 | 0.60 | 278.52 |
| Jun-11 | 1.10 | 0.06 | 21.57 | 0.13 | 0.01 | 1.81 | 1.41 | 0.02 | 99.68 | 0.30 | 0.00 | 19.12 |
| SCIP-Card-2†† | ||||||||||||
| Mar-11 | 0.65 | 0.10 | 4.21 | 0.71 | 0.12 | 4.24 | 0.60 | 0.02 | 22.73 | 0.55 | 0.02 | 15.94 |
| Apr-11 | 0.69 | 0.11 | 4.44 | 0.43 | 0.08 | 2.21 | 0.36 | 0.01 | 13.15 | 0.18 | 0.01 | 4.20 |
| May-11 | 0.61 | 0.13 | 2.85 | 0.36 | 0.08 | 1.50 | 0.52 | 0.02 | 16.81 | 0.23 | 0.01 | 6.26 |
| Jun-11 | 0.79 | 0.04 | 16.64 | 0.67 | 0.05 | 8.89 | 1.86 | 0.02 | 161.00 | 1.27 | 0.02 | 95.91 |
†
This is the main analysis, where the before-phase extends from October 1, 2010, to March 4, 2011, and the after-phase extends from March 5, 2011, to June 10, 2011.
‡
Reflective of performance on all the Surgical Care Improvement Project measures:
- Fit statistics for adjusted one-group pre- and post-EHR logistic regression: Hosmer–Lemeshow (HL) Test Statistic: 8.97, p = .34; C Statistic: 0.72; Link Test: Square term p = .29
- Fit statistics for adjusted DID estimation: HL Test Statistic: 5.82, p = .67, C Statistic: 0.75, Link Test: Square term p = .64
§
Cardiac surgery patients with controlled 6 a.m. postoperative blood glucose:
- Fit statistics for adjusted one-group pre- and post-EHR logistic regression: HL Test Statistic: 5.33, p = .72; C Statistic: 0.87; Link Test: Square term p = .87
¶
Urinary catheter removed on postoperative day 1 or 2:
- Fit statistics for adjusted one-group pre- and post-EHR logistic regression: HL Test Statistic: 4.55, p = .80; C Statistic: 0.92; Link Test: Square term p = .10
- Fit statistics for adjusted DID estimation: HL Test Statistic: 7.83, p = .45; C Statistic: 0.92; Link Test: Square term p = .22
††
Surgery patients on beta-blocker therapy prior to arrival who received a beta-blocker during the perioperative period:
- Fit statistics for adjusted one-group pre- and post-EHR logistic regression: HL Test Statistic: 8.81, p = .36; C Statistic: 0.89; Link Test: Square term p = .37
- Fit statistics for adjusted DID estimation: HL Test Statistic: 10.25, p = .25; C Statistic: 0.92; Link Test: Square term p = .25
‡‡
Cardiac surgeries are not performed at Highland Hospital (HH); hence HH cannot be used as a comparator group.
OR, odds ratio; LCL, lower confidence limit; UCL, upper confidence limit.
**
p ≤ .05;
*
p ≤ .10.