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Health information technology (IT) has been championed as a tool that can transform health care delivery. We estimate the parameters of a value-added hospital production function correcting for endogenous input choices to assess the private returns hospitals earn from health IT. Despite high marginal products, the total benefits from expanded IT adoption are modest. Over the span of our data, health IT inputs increased by more than 210% and contributed about 6% to the increase in value-added. Not-for-profits invested more heavily and differently in IT. Finally, we find no compelling evidence of labor complementarities or network externalities from competitors' IT investment. Disciplines ABSTRACTThe US health care sector is, by most accounts, extraordinarily inefficient. Health information technology (IT) has been championed as a tool that can transform health care delivery. Recently, the federal government has taken an active role in promoting health IT diffusion. There is little systematic analysis of the causal impact of health IT on productivity or whether private and public returns to health IT diverge thereby justifying government intervention. We estimate the parameters of a value-added hospital production function correcting for endogenous input choices in order to assess the private returns hospitals earn from health IT. Despite high marginal products, the potential benefits from expanded IT adoption are modest. Over the span of our data, health IT inputs increased by more than 210% and contributed about 6% to the increase in value-added. Virtually all the increase in value-added is attributable to the increased use of inputs{there was little change in hospital multi-factor productivity. Not-for-profits invested more heavily and differently in IT than for-profit hospitals. Finally, we find no evidence of labor complementarities or network externalities from health IT.

Variables affecting the passivation capability of Cu(Mg) alloy films, which were sputter deposited from a Cu (4.5 atom %) target, have been investigated. As-deposited Cu(Mg)/SiO 2 /Si multilayer samples were annealed for 30 min in various oxygen ambients at pressures ranging from 10 mTorr to 30 Torr and at various temperatures in the 200-800ЊC range. The results show that the passivation capability of a Cu(Mg) alloy film is a function of annealing temperature, O 2 pressure, and Mg content in the film. Increasing the annealing temperature favors formation of a dense MgO layer on the surface. Decreasing the O 2 pressure enhances the preferential oxidation of Mg over Cu. Furthermore, increasing the Mg content in the Cu(Mg) film promotes formation of a dense MgO layer. Vacuum preannealing before taking the as-deposited samples to O 2 annealings was found to be very effective in segregating Mg to the surface, facilitating the passivation capability of the Cu(Mg) alloy film even when the Mg content is low. In the current study, self-aligned MgO layers with low resistivity and an effective passivation capability over the Cu surface have been obtained by manipulating these factors when Cu(Mg) thin films are annealed.

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BackgroundThe electronic medical record (EMR) is one of the most promising components of health information technology. However, the overall impact of EMR adoption on outcomes at US hospitals remains unknown. This study examined the relationship between basic EMR adoption and 30-day rehospitalization, 30-day mortality, inpatient mortality and length of stay.MethodsOur overall approach was to compare outcomes for the two years before and two years after the year of EMR adoption, at 708 acute-care hospitals in the US from 2000 to 2007. We looked at the effect of EMR on outcomes using two methods. First, we compared the outcomes by quarter for the period before and after EMR adoption among hospitals that adopted EMR. Second, we compared hospitals that adopted EMR to those that did not, before and after EMR adoption, using a generalized linear model.ResultsHospitals adopting EMR experienced 0.11 (95% CI: -0.218 to −0.002) days’ shorter length of stay and 0.182 percent lower 30-day mortality, but a 0.19 (95% CI: 0.0006 to 0.0033) percent increase in 30-day rehospitalization in the two years after EMR adoption. The association of EMR adoption with outcomes also varied by type of admission (medical vs. surgical).ConclusionsPrevious studies using observational data from large samples of hospitals have produced conflicting results. However, using different methods, we found a small but statistically significant association of EMR adoption with outcomes of hospitalization.