People who are treated by doctors who work at hospitals instead of clinics have shorter hospital stays and spend less money on treatment, a new study shows.
A study by the Department of Veterans Affairs Iowa City Health Care System and University of Iowa researchers showed factors associated with reduced hospital costs and length of stay that accompany care by "hospitalists" — doctors who devote their time to taking care of hospitalized patients rather than having an outside clinical practice.
The team analyzed 1,706 patient admissions in 2000-2001 to the four general internal medicine services at University Hospitals in Iowa City. One service was staffed solely by hospitalists; the others by non-hospitalist physicians in internal medicine.
The investigators found patients cared for by the hospitalists averaged a one-day shorter length of stay at 5.5 days compared to 6.5 days. They also had a 10 percent reduction in hospital costs.
Hospitalization costs for hospitalist patients averaged $917 less than non-hospitalist patients. Greatest savings were in costs of in-hospital nursing services, likely related to shortened stays.
Dr. Peter Kaboli, the study's lead author and an assistant professor in the University of Iowa Carver College of Medicine, said with nursing shortages, shorter stays are important.
Kaboli, a VA researcher, said previous studies have shown hospitalists improve efficiency of care, but this study is the first to separate cost categories to identify where the greatest savings occur.
"Believe it or not, patients don't like to be in the hospital," said Kaboli, one of five hospitalists at University Hospitals. "They like to get the care they need and then go home."
Because hospitalists are familiar and comfortable with the hospital environment, Kaboli said they know how to order tests and otherwise efficiently get patients the help they need, both in the hospital and in arranging nursing services after discharge.
Analysis of readmission rates showed shorter stays did not mean hospitalist patients were being sent home before they were stable. Both categories of patients were readmitted within 30 days about 8 percent of the time.