title: Employing infectious disease physicians affects clinical and economic outcomes in regional hospitals: evidence from a population-based study.
abstract: OBJECTIVE
  Infectious disease physicians (IDPs) play a major role in patient care, infectious disease control, and antibiotic use in hospitals. The aim of this research is to explore the effects of employment of IDPs on patients' prognosis and the related medical and antibiotic expenses in hospitals.
  
  
  METHODS
  This population-based study provides evidence-based information on IDPs' contribution to patients' prognosis and antibiotic expenditure containment with inpatient claim data from the Taiwan Bureau of National Health Insurance in 2004. We further classified regional hospitals into those with and without IDPs and analyzed patient prognosis, length of stay, total medical expenses, and antibiotic expenses to test the effects of IDPs.
  
  
  RESULTS
  The likelihood of developing a poor prognosis among patients was found to be higher in non-IDP hospitals, with an odds ratio of 1.14 and a 95% confidence interval of 1.05-1.23 (p = 0.002). Medical expenses, excluding those of nonrestricted drugs, were found to be higher in the non-IDP group than in the IDP group. The total medical expenses were also found to be 10% higher in the non-IDP group than in the IDP group (p < 0.001).
  
  
  CONCLUSIONS
  Employment of IDPs was likely to improve patient prognosis and reduce overall medical expenses. It is suggested that healthcare administrators consider the employment of or investment in IDPs as a cost-effective strategy for improving patient quality of care.
authors.affiliation: Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Laboratory for Epidemiology, Department of Health Care Management, Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chia-Pang
authors.initials: CP
authors.lastname: Shih
authors.affiliation: Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Department of Pharmacy, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan.
authors.forename: Yuk-Ying
authors.initials: YY
authors.lastname: Chan
authors.affiliation: Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Laboratory for Epidemiology, Department of Health Care Management, Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan. Electronic address: khsu@mail.cgu.edu.tw.
authors.forename: Kuang-Hung
authors.initials: KH
authors.lastname: Hsu
mesh_terms: D000328:Adult; D000368:Aged; D003140:Communicable Disease Control; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D005251:Fees, Medical; D005260:Female; D020445:Hospitalists; D006761:Hospitals; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D062486:Public Health Surveillance; D013624:Taiwan
keywords: Antibiotic prescriptions; Infectious disease physicians; Regional hospitals; Total medical expenses; Treatment outcomes