Study indicates why hospitalists improve hospital efficiency

You may not be familiar with the term but you might find yourself being treated by a "hospitalist" -- a physician who devotes all or most of his or her clinical time to the care of certain hospitalized patients. Previous studies have shown that hospitalist services improve efficiency of care by reducing hospital costs and length of stay, without compromising quality or patient satisfaction.

Now, researchers at the Department of Veterans Affairs (VA) Iowa City Health Care System and the University of Iowa have identified some factors associated with these efficiencies. The study results appear in the August issue of The American Journal of Managed Care.

Hospitalists, usually physicians in general internal medicine, serve as attending physicians for patients who are directed to inpatient care by their primary care provider or the emergency department. These patients are not sick enough to require treatment in an intensive care unit but have urgent, non-scheduled care needs for conditions such as pneumonia, liver disease, heart failure or diabetes complications.

The team analyzed 1,706 patient admissions in 2000-2001 to the four general internal medicine services at UI Hospitals and Clinics. One service was staffed solely by hospitalists and the three other services by non-hospitalist physicians in internal medicine. The investigators found that patients cared for by the hospitalists had on average a one-day shorter length of stay (5.5 vs. 6.5 days) and a 10 percent reduction in hospital costs.

Hospitalization costs for hospitalist patients were an average of $917 less than costs for non-hospitalist patients. The researchers demonstrated that the greatest savings were in the cost of in-hospital nursing services, likely directly related to the shortened length of stay.

"In these times of limited financial resources, hospitalists are seen as a way to potentially improve the efficiency of inpatient care. This study is the first

Contact: Becky Soglin
University of Iowa

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