Study ties hospitalist care to shorter patient stays

Organized medicine leaders acknowledge the findings but stress the importance of continuity of care.

By Myrle Croasdale, AMNews staff. Jan. 28, 2008.

Hospitalists trimmed 12% from the average hospital patient's stay, the equivalent of about a half-day off an average four-day visit.

That is the conclusion of a study published in the Dec. 20, 2007, New England Journal of Medicine.

"On first glance, this might appear to be a small difference," said Peter Lindenauer, MD, the study's lead author. "But multiply it out by 6,000 acute care hospitals, and you can see a dramatic impact on hospital efficiencies."

The study, the largest of its kind regarding hospitalists, also found that patients cared for by hospitalists had slightly lower costs per stay than those treated by a general internist or family physician. Patient outcomes were similar regardless of whether they were treated by a hospitalist, internist or family physician.

Dr. Lindenauer, who practices at Baystate Medical Center in Springfield, Mass., and is an associate professor of internal medicine at Tufts University School of Medicine in Boston, said the study's overall results should give hospitalists better bargaining power.

"Most hospitalist programs are not able to support themselves entirely through professional fees," Dr. Lindenauer said. "These kinds of demonstrated savings should help hospitalist programs during their negotiation with hospitals around program support."

Laurence McMahon Jr., MD, MPH, internal medicine division chief at the University of Michigan Health System in Ann Arbor, wrote a New England Journal of Medicine editorial in response to the study. He said the findings ought to end the debate regarding hospitalists' value. Now he would like to see researchers pursue topics like hospitalists' impact on quality improvement or patient safety.