Although it has been widely believed that the hospitalist model of care reduces hospital length of stay one of the largest and highest quality studies comparing hospitalist and non-hospitalist care, which showed no differences in utilization, was suppressed and not included in any of several systematic reviews on the subject. Thus, up to now, the data have been mixed and the overall effect of hospitalist care was not known.
But a newly published study of a large Medicare database tips the balance of evidence in favor of the hospitalist model. It showed not only a reduced length of stay but an increase in the magnitude of the effect over time through 2006:
RESULTS: In multivariable analyses controlling for patient and hospital characteristics, differences in LOS associated with hospitalist care increased from 0.02 fewer days in 2001/02 to 0.22 days in 2003/04 to 0.35 days in 2005/06. For 2006 admissions, differences in LOS were greater in older patients and patients with a higher diagnosis-related group (DRG) weight. The differences were three times as great for medical as for surgical DRGs, with greater differences in LOS at nonprofit than for-profit hospitals and at community than teaching hospitals.
Boosters of the movement have been making this claim for years. Only now do they have the weight of evidence behind that claim.
Free full text at Medscape.
No comments:
Post a Comment