Should a Cardiologist be the Principal Attending Physician or the Consultant to a Hospitalist or General Internist for Cardiovascular Disease Admissions?
Cardiologists may be the principal attending physician or the consultant to general internists or hospitalists in hospitalized patients with cardiovascular diseases. To find out which role may be best for quality and efficiency, a retrospective cohort study of 15, 113 patients in 11 cardiovascular diagnosis groups was carried out. Hospital cost, length of stay, mortality, and 30-day readmissions were compared among attending physicians who were hospitalists, general internists, or cardiologists. After adjustment for differences in demography and severity, cardiologists generally had substantially lower cost and length of stay compared with internists or hospitalists, especially when the diagnosis group included a cardiovascular procedure. Hospitalists and internists did not differ substantially in cost or length of stay. There were no statistically significant differences among the physician groups in mortality or 30-day readmissions. In conclusion, cardiologists may be the more efficient attending physician for selected cardiovascular diseases, especially when procedures are involved.
Program Director, Internal Medicine Residency Program, Florida Hospital Medical Center, 2501 North Orange Avenue, Orlando, FL 32804. E: george.everett.md@flhosp.org.
George
G
Everett
Professor of Statistics, University of Central Florida.
Nizam
N
Uddin