Abstract
Purpose
Many studies have documented significant length of stay reduction and cost savings
when hospitalist care is compared with traditional care. However, less is known about
the concurrent performance of more than one hospitalist model in a single site.
Subjects and methods
This retrospective cohort study of 10 595 patients was conducted between July 2001 and June 2002 in a tertiary care community-based
teaching hospital. Risk-adjusted length of stay, variable costs, 30-day readmission
rates, and in-hospital and 30-day mortality were measured for patients treated by
Community Physicians, Private Hospitalists and Academic Hospitalists.
Results
There was a 20% reduction in length of stay on the Academic Hospitalist service (p <.0001) and 8% on the Private Hospitalist service (P = .049) compared with Community Physicians. Similarly, total costs were 10% less
on the Academic (P <.0001) and 6% less on the Private Hospitalist (P = .02) services compared with Community Physicians. The length of stay of Academic
Hospitalists was 13% shorter than that of Private Hospitalists (P = .002); differences in costs between hospitalist groups were not statistically significant.
Differences in in-hospital and 30-day mortality and 30-day readmission rates among
the 3 physician groups were also not statistically significant.
Conclusions
The impact on patient outcomes and resource utilization may vary with the hospitalist
model used. Future studies should examine the specific organizational characteristics
of hospitalists that contribute to improved patient care and resource utilization.
Keywords
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Article info
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© 2005 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
