Comparison of hospitalists and nonhospitalists regarding core measures of pneumonia care.
OBJECTIVE
To examine whether compliance with national indicators of care differed amongst hospitalists and nonhospitalists.


METHODS
Retrospective, observational cohort study.


METHODS
Patients admitted from September 2004 through January 2005 to a community teaching hospital with a principal diagnosis of community-acquired pneumonia were included. Patient exclusions were any immunosuppressive illness or therapy within the past 3 months, comfort care only, or care provided by house staff. Patient variables of age, length of stay (LOS), time to initial antibiotic therapy, blood cultures drawn, use of deep venous thrombosis (DVT) prophylaxis, administration of pneumococcal vaccine or documentation of ineligibility for it, and name of attending physician were collected. Dichotomous variables were compared using chi(2)-analysis, and continuous variables were compared using the Student t test.


RESULTS
A total of 158 patients were treated by 58 physicians; 68 patients by 12 hospitalists and 90 patients by 46 nonhospitalists. Patients did not differ in age, LOS, likelihood of receiving timely antibiotics, or having blood cultures drawn before antibiotics. Hospitalist patients were more likely to have been given inpatient DVT prophylaxis (96.9% vs 61.9%; P < .001) and to have had a pneumococcal vaccine administered or a documented reason why it was not given (88.2% vs 65.6%; P = .001).


CONCLUSIONS
This is the first study to suggest that pneumonia patients cared for by hospitalists were more likely to receive 2 important quality care processes.
Rifkin
William D
WD
Department of Medicine, Yale University School of Medicine, New Haven, CT, USA. william.rifkin@yale.edu
Burger
Alfred
A
Holmboe
Eric S
ES
Sturdevant
Bonnie
B
D000368:Aged; D001291:Attitude of Health Personnel; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000517:prevention & control / Q000628:therapy; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D020445:Hospitalists / Q000592:standards*; D006764:Hospitals, Community; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family / Q000592:standards*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D011018:Pneumonia, Pneumococcal / Q000517:prevention & control* / Q000628:therapy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011336:Probability; D019984:Quality Indicators, Health Care; D012189:Retrospective Studies; D014481:United States; D014611:Vaccination / Q000592:standards / Q000639:trends
D022242:Pneumococcal Vaccines