# Associations Between Hospital Structural Characteristics and Adoption of Public Health Data Integration and Automation: National Cross-Sectional proofsStudy

## TL;DR

This study explores how hospital characteristics affect the adoption of public health data integration and automation systems, finding that larger and system-affiliated hospitals are more likely to use these technologies.

## Contribution

The study provides new insights into hospital factors influencing public health data automation adoption, highlighting disparities in rural and smaller hospitals.

## Key findings

- System-affiliated and not-for-profit hospitals have higher rates of electronic data submission and automated reporting.
- Rural hospitals show lower adoption rates in several public health reporting categories.
- Larger hospitals are more engaged in syndromic surveillance reporting compared to smaller ones.

## Abstract

Public health data integration and automation systems are crucial for effective health care delivery and public health surveillance. However, the factors associated with hospitals’ adoption and successful implementation remain inadequately explored.

This study aims to examine how hospital characteristics influence the adoption of public health data integration and automation.

We analyzed 2277 hospitals from the 2023 American Hospital Association Annual Survey and its Health Information Technology supplement, focusing on 6 public health reporting categories. Multivariable logistic regression models were used to examine the association between hospital characteristics and the 2 primary outcomes: active electronic data submission and use of automated transmission processes.

System-affiliated and not-for-profit hospitals demonstrated significantly higher rates of electronic data submission and automated reporting across most categories (odds ratio [OR] 1.70‐2.27; P<.001). Rural hospitals showed lower adoption rates in immunization registry (OR 0.77, 95% CI 0.61-0.97), public health registry (OR 0.67, 95% CI 0.46-0.97), and clinical data registry reporting (OR 0.77, 95% CI 0.60-0.98). Larger hospitals were more likely to implement electronic reporting, with medium and large hospitals showing stronger engagement in syndromic surveillance reporting (OR 1.52, 95% CI 1.06-2.19 and OR 2.29, 95% CI 1.17-4.46, respectively). Teaching status was significantly associated only with clinical data registry reporting (OR 2.66, 95% CI 1.56-4.52 for major teaching hospitals).

Hospital characteristics, particularly system affiliation, ownership type, and geographic location, are strongly associated with public health data integration and automation capabilities. Findings suggest targeted interventions are needed to address disparities in smaller and rural facilities to ensure equitable advancement of public health reporting infrastructure.