Using Electronic Medical Records in Admission Decisions: A Cost Effectiveness Analysis
研究了急诊科使用电子病历系统对急性心肌梗死患者入院决策的影响，通过决策树和马尔可夫模型进行成本效果分析，发现使用电子病历在疑似心梗病例中更具成本效果。
ABSTRACT In recent years, the healthcare sector has invested heavily in medical information systems to improve decision making while reducing medical costs and integrating medical data from multiple sources. However, the overall contribution of this technology to the medical field remains controversial, especially in high‐stress environments such as the emergency department. This article evaluates the differential effects of accessing an electronic medical record (EMR) system on the decision to admit, based on diagnosis of acute myocardial infarction (AMI), which is one of the main reasons people go to the emergency department. The admission decision with or without accessing the EMR system is modeled as a decision tree and a Markovian process. A cost‐effectiveness analysis compares the added value of information (retrieved from the EMR system) against the cost of providing this information. This model is then tested on a simulation of patients presenting symptoms of AMI. The results show that use of the EMR led to greater cost‐effectiveness in cases of suspected AMI. The findings of this study may assist physicians by demonstrating a probable contribution of EMR to improved medical outcomes and may inform policy makers in the healthcare sector regarding the advisability of investing in such systems in an emergency department.