The Cost and Efficiency of Hospital Care Provided by Primary Care Physicians and Medical Subspecialists

There is a perceived excess of subspecialists compared with primary care doctors, but there are few severity-adjusted data that characterize the care provided by these physician groups. In a nationwide hospital network, we studied outcomes of 17,185 patients who were hospitalized for 1 of 9 common i...

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Veröffentlicht in:American journal of medical quality 1999-09, Vol.14 (5), p.197-201
Hauptverfasser: Zarling, Edwin J., Piontek, Frank A., Kohli, Rajiv, Carrier, James
Format: Artikel
Sprache:eng
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Zusammenfassung:There is a perceived excess of subspecialists compared with primary care doctors, but there are few severity-adjusted data that characterize the care provided by these physician groups. In a nationwide hospital network, we studied outcomes of 17,185 patients who were hospitalized for 1 of 9 common internal medicine illnesses. For 4 of 9 conditions, the subspecialists treated more severely ill ( P < .001) patients. The raw total charges for their care were higher ( P < .002) for 4 of 9 conditions and longer stays were required for 2 conditions. After adjusting for severity of illness, differences between the physician groups became minimal. In nine-severity adjusted medical illnesses, subspecialists and primary care physicians provide care that produces similar results for length of stay, charge, and mortality. Health care manpower projections should be re-evaluated in light of this information.
ISSN:1062-8606
1555-824X
DOI:10.1177/106286069901400502