Comparison of hospital costs and length of stay for community internists, hospitalists, and academicians.
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.


METHODS
Single-institution retrospective cohort study.


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.
Everett
George
G
Internal Medicine Residency Program, Orlando Regional Healthcare, Orlando, FL 32806, USA. George.Everett@orhs.org
Uddin
Nizam
N
Rudloff
Beth
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D017721:Hospital Costs; D020445:Hospitalists / Q000191:economics; D006764:Hospitals, Community / Q000191:economics*; D006801:Humans; D007388:Internal Medicine / Q000191:economics; D007902:Length of Stay / Q000191:economics*; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000191:economics*; D010821:Physicians, Family / Q000191:economics; D012189:Retrospective Studies