Table 4.

Relationship between EHR Adoption and Hospital Outcomes by Meaningful Use Attestation Cohort

	Process Compositea	Patient Satisfaction Compositeb	Efficiencyc
EHR adoption*Attestation cohort 1	0.202***	0.243***	−0.0145
EHR adoption*Attestation cohort 2	0.194***	0.0861**	−0.0184
EHR adoption*Attestation cohort 3	0.230***	0.0787	0.0872**
EHR adoption*Never attested	−0.194*	0.0368	−0.00645
Observationsd	10,152	9,327	11,363
p‐value from F‐test comparing
Cohort 1 versus 2	0.9351	0.0059	0.9752
Cohort 1 versus 3	0.8128	0.0123	0.1340
Cohort 1 versus never	0.0021	0.0091	0.7945
Cohort 2 versus 3	0.7431	0.9031	0.1215
Cohort 2 versus never	0.0015	0.5101	0.7644
Cohort 3 versus never	0.0018	0.06049	0.1131

Covariates include hospital case mix index, market share, size, teaching status, system membership, network membership, ownership, year, and hospital fixed effects. Standard errors are clustered at the hospital level. Bold values indicate those f‐tests that are statistically significant at the level of p < 0.05.

^aThe Process measure is a composite of 10 process measures drawn from CMS's Hospital Compare data that have been log‐transformed to reduce skew and standardized.

^bPatient satisfaction is a composite of the Hospital Consumer Assessment of Healthcare Providers and Systems, including measures of Communication with Nurses, Communication with Doctors, Responsiveness of Hospital Staff, Pain Management, Cleanliness and Quietness of Hospital Environment, Communication about Medicines, Discharge Information, and Overall Rating of Hospital.

^cEfficiency is measured as the total expenditures per adjusted patient day.

^dHospitals were fairly evenly split across the attestation cohorts. Eighteen percent of hospitals first attested in 2011; 38% first attested in 2012; 24% first attested in 2013; and 20% never attested. The number of observations for each model varies due to the number of respondents to each outcome measure.

***p < .01, **p < .05, *p < .10.