Rising Hospitalist Workload May Lead to Increasing Lengths of Stay & Costs — Physician’s First Watch
Rising Hospitalist Workload May Lead to Increasing Lengths of Stay & Costs
By Joe Elia
Hospitalists' workloads, as they rise, are associated with increasing medical costs and longer lengths of stay, a JAMA Internal Medicine study finds.
Researchers retrospectively examined the work of a single hospitalist group that attended some 20,000 admissions over a 3-year period. Workloads were determined from the number of relative value units generated and the number of patients with whom the hospitalist had a billable encounter.
The study's primary efficiency measures, length of stay and cost, were both adversely affected by increasing workload. The quality measures of in-hospital mortality, rapid-response team activation, and patient satisfaction were not affected.
A commentator emphasizes that for each patient that a hospitalist saw beyond 15 per day, the mean length of stay increased by 2 full days and hospital costs by $262. He concludes that, although 15 may not be the magic number, programs that run higher should consider hiring more physicians or nonphysician providers.