社区内科医生、住院医师和院士的住院费用及住院时间比较。
Comparison of hospital costs and length of stay for community internists, hospitalists, and academicians.
作者信息
Everett George, Uddin Nizam, Rudloff Beth
机构信息
Internal Medicine Residency Program, Orlando Regional Healthcare, Orlando, FL 32806, USA.
出版信息
J Gen Intern Med. 2007 May;22(5):662-7. doi: 10.1007/s11606-007-0148-x. Epub 2007 Mar 6.
BACKGROUND
The model of inpatient medical management has evolved toward Hospitalists because of greater cost efficiency compared to traditional practice. The optimal model of inpatient care is not known.
OBJECTIVE
To compare three models of inpatient Internal Medicine (traditional private practice Internists, private Hospitalist Internists, and Academic Internists with resident teams) for cost efficiency and quality at a community teaching hospital.
DESIGN
Single-institution retrospective cohort study.
MEASUREMENTS AND MAIN RESULTS
Measurements were hospital cost, length of stay (LOS), mortality, and 30-day readmission rate adjusted for severity, demographics, and case mix. Academic Internist teams had 30% lower cost and 40% lower LOS compared to traditional private Internists and 24% lower cost and 30% lower LOS compared to private Hospitalists. Hospital mortality was equivalent for all groups. Academic teams had 2.3-2.6% more 30-day readmissions than the other groups.
CONCLUSIONS
Academic teams compare favorably to private Hospitalists and traditional Internists for hospital cost efficiency and quality.
背景
由于与传统医疗模式相比具有更高的成本效益，住院医疗管理模式已向住院医师模式发展。目前尚不清楚最佳的住院治疗模式。
目的
在一家社区教学医院比较三种内科住院治疗模式（传统私人执业内科医生、私立住院医师内科医生和带住院医师团队的学术内科医生）的成本效益和质量。
设计
单机构回顾性队列研究。
测量指标及主要结果
测量指标包括医院成本、住院时间（LOS）、死亡率以及根据病情严重程度、人口统计学特征和病例组合调整后的30天再入院率。与传统私人执业内科医生相比，学术内科医生团队的成本降低了30%，住院时间缩短了40%；与私立住院医师内科医生相比，则成本降低了24%，住院时间缩短了30%。所有组的医院死亡率相当。学术团队的30天再入院率比其他组高2.3%-2.6%。
结论
在医院成本效益和质量方面，学术团队优于私立住院医师内科医生和传统内科医生。
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