Examining the joint effect of clinical quality, meaningful use of HIT and patient-caregiver interaction on mortality rates in US acute care hospitals.

Background: Healthcare quality has long been defined and assessed using different theories that outline care delivery as a product of two factors; one being the clinical aspect symbolizing the science of care and the other being the non-clinical aspect symbolizing non-medicinal aspect of care delivery. To the best of our knowledge, the joint effect of the clinical, social and technological aspects of care on outcome quality has not been investigated in the literature. The current study empirically investigates the joint effect of the clinical, social and technological care quality dimensions on mortality rates through analyzing longitudinal data from 3081 US hospitals.

Methods: Six-year data from more than 3000 acute care hospitals is analyzed using econometric analysis with two stage least square instrumental variable regression models.

Results: Hospitals that jointly focus on clinical, social and technological care dimensions realize lower mortality rates. Combining clinical quality (CM) with either meaningful use of health information technology (MUHIT) or patient-caregiver interaction (PCI) reduces mortality rates. The lowest mortality rate is realized when hospitals combine CM, PCI and MUHIT.

Conclusion: Our study provides empirical evidence on the importance of combining clinical and non-clinical care measures to reduce mortality rates in hospitals. Our results indicate that hospitals that combine dual quality dimensions, clinical quality with either PCI or MUHIT, can also realize improvement in mortality rates. However, the best outcome can be realized by focusing on the triple quality dimensions (CM, PCI and MUHIT). The study provides pointers to healthcare professionals and policy makers on the impact of non-clinical care on the clinical-mortality link in hospitals.