Alexandraki Irene, Palacio Carlos, House Jeffrey, Mooradian Arshag D
David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA.
Health Care Manag (Frederick). 2012 Oct-Dec;31(4):295-301. doi: 10.1097/HCM.0b013e31826fe26c.
A study was undertaken to determine whether hospital bed utilization is different between teaching and nonteaching hospitalist services. During a 2-year period, the average length of stay (ALOS), case-mix index, readmissions within 30 days of discharge, and percentage of 1-day stays were compared between these services. To ameliorate confounders, the ALOS was recalculated (ALOS revised) after excluding patients with length of stay of more than 20 days and those originally admitted to the intensive care unit. Six thousand ninety-nine patients were discharged by the teaching service (group 1), 14 348 by the corporate hospitalist (group 2), and 2634 by the community-based practitioner group (group 3). The mean ALOS revised was significantly lower for the teaching service (3.64 ± 2.22 days) compared with the other 2 services (4.53 ± 1.48 and 4.73 ± 1.02, respectively [P < .001]), although the mean case-mix index was significantly higher for the teaching service compared with the other services. The mean percentage of readmissions within 30 days of discharge and 1-day stays were not significantly different between group 1 and groups 2 and 3. Hospital bed utilization in the teaching service was superior to the nonteaching hospitalist services. Further research should explore the reasons for the differences between these models of care.
开展了一项研究，以确定教学医院和非教学医院的住院医师服务在病床使用方面是否存在差异。在为期2年的时间里，对这些服务的平均住院时间（ALOS）、病例组合指数、出院后30天内的再入院率以及住院1天的患者比例进行了比较。为了减少混杂因素，在排除住院时间超过20天的患者和最初入住重症监护病房的患者后，重新计算了平均住院时间（修订后的ALOS）。教学服务组（第1组）有6099例患者出院，公司住院医师组（第2组）有14348例，社区执业医师组（第3组）有2634例。与其他两组服务相比，教学服务组修订后的平均ALOS显著更低（3.64±2.22天），而其他两组分别为4.53±1.48天和4.73±1.02天（P<.001），尽管教学服务组的平均病例组合指数显著高于其他服务组。第1组与第2组和第3组出院后30天内的再入院平均百分比和住院1天的平均百分比没有显著差异。教学服务的病床使用情况优于非教学医院的住院医师服务。进一步的研究应探索这些护理模式之间差异的原因。
