Comparing Hospitalist-Resident to Hospitalist-Midlevel Practitioner Team Performance on Length of Stay and Direct Patient Care Cost

• DOI: 10.4300/jgme-d-14-00234.1
• Publication Date: 2014-12-19T21:39:17Z
• Authors: Michael C. Iannuzzi; James C. Iannuzzi; Andrew Holtsbery; Stuart M. Wright; Stephen J. Knohl
• Keywords: Staffing; Graduate medical education; Hospital medicine; Demographics; Inpatient care; Patient Care; Physician assistants

A perception exists that residents are more costly than midlevel providers (MLPs). Since graduate medical education (GME) funding is a key issue for teaching programs, hospitals should conduct cost-benefit analyses when considering staffing models.Our aim was to compare direct patient care costs and length of stay (LOS) between resident MLP inpatient teams.We queried the University HealthSystems Consortium clinical database (UHC CDB) 13 553 "inpatient" discharges at our institution from July 2010 June 2013. Patient assignment based on bed availability rather "educational value." Using UHC CDB data, teams were compared observed expected LOS, cost derived hospital charges, relative mortality (REM), readmissions. We also satisfaction physician domain questions using Press Ganey data. Bivariate analysis performed factors associated with differences 2 services χ(2) Student t test categorical continuous variables, respectively.During 3-year period, while REM higher hospitalist-resident (P < .001), LOS shorter by 1.26 days, per-patient charges lower $617. scores physician-selected teams. There no in demographics, daily discharge rates, readmissions, or deaths.Resident economically efficient have satisfaction. The findings offer guidance GME models.