Comparison of a Family Practice Teaching Service and a Hospitalist Model: Costs, Charges, Length of Stay, and Mortality

摘要

BACKGROUND AND OBJECTIVES: One third of our nation's health care costs are incurred in the hospital. This study compares the inpatient outcomes between a family practice teaching service (FPTS) and a hospitalist group in the same suburban community hospital. METHODS: All patients discharged by the hospitalist group or the FPTS between April 1998 and June 1999 were included for study if they had one of the 10 most frequent principal diagnoses on discharge. The outcomes compared between the groups were length of stay, mortality, total charges, laboratory charges, radiology charges, and direct costs. Student's t test, chi-square, and analysis of variance were used to compare the outcomes, after adjusting data for severity of illness. RESULTS: Mean severity of illness for the FPTS patients was 2.42 and for the hospitalist patients was 2.26, with higher scores indicating greater severity of illness. After adjusting for severity of illness, there were no differences between the two groups of physicians for total charges, laboratory charges, radiology charges, direct costs, length of stay, or mortality rates. CONCLUSIONS: This study failed to demonstrate a statistically significant difference in the use of hospital resources between a family practice residency teaching service and a hospitalist team. Given the outcomes measured in this community teaching hospital, the residency teaching service appears to be a financially competitive model for delivery of inpatient care.