The hospitalist specialty is one of the fastest growing specialties in the country, largely because of the perceived association with hospital length of stay and costs. However, until recently, no national study had examined the effects of hospitalist-provided care on hospital costs, medical utilization after discharge, or costs after discharge.
Two researchers from the University of Texas Medical Branch set out to determine the effect of hospitalists on hospital costs. Published in the August 2, 2011 Annals of Internal Medicine, the study concluded that the decreased length of stay and hospital costs associated with care provided by hospitalists are offset by increased medical utilization and costs after discharge.
The study authors—Yon-Fang Kuo, PhD, and James S. Goodwin, MD—performed a population-based national cohort study using a 5% sample of Medicare parts A and B enrollees who had primary care physicians and were cared for by either that provider or a hospitalist during medical hospitalizations between 2001 and 2006. For about 58,000 patients involved in the study, measurements were taken for length of stay, hospital charges, discharge location, physician visits, ED visits, rehospitalization, and Medicare spending up to 30 days after discharge.
Following a propensity score analysis, Drs. Kuo and Goodwin found that average hospital length of stay was 0.64 days fewer and hospital charges were $282 less for those who received care from hospitalists compared with those receiving care from their primary care physician. However, Medicare costs were $332 higher, on average, for those in the former group, adding up to what the researchers say is potentially an extra $1.1 billion for all patients with Medicare.
Physician’s Weekly wants to know…
- Do these study findings change your point of view on hospitalist-provided care?
- Do you think hospitalists are pressured to shorten hospital lengths of stay to save hospital costs?