Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Association of resident coverage with cost, length of stay, and profitability at a community hospital
Autore:
Shine, D; Beg, S; Jaeger, J; Pencak, D; Panush, R;
Indirizzi:
Monmouth Med Ctr, Dept Med, Long Branch, NJ 07740 USA Monmouth Med Ctr Long Branch NJ USA 07740 Med, Long Branch, NJ 07740 USA Monmouth Med Ctr, Dept Med Educ, Long Branch, NJ 07740 USA Monmouth Med Ctr Long Branch NJ USA 07740 Educ, Long Branch, NJ 07740 USA St Barnabas Hlth Care Syst, Dept Decis Support, Livingston, NJ USA St Barnabas Hlth Care Syst Livingston NJ USA Support, Livingston, NJ USA St Barnabas Med Ctr, Dept Med, Livingston, NJ USA St Barnabas Med Ctr Livingston NJ USA Ctr, Dept Med, Livingston, NJ USA
Titolo Testata:
JOURNAL OF GENERAL INTERNAL MEDICINE
fascicolo: 1, volume: 16, anno: 2001,
pagine: 1 - 8
SICI:
0884-8734(200101)16:1<1:AORCWC>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
GRADUATE MEDICAL-EDUCATION; NONTEACHING HOSPITALS; TEACHING STATUS; CASE-MIX; SEVERITY;
Keywords:
health care finance; residents; length of stay; indirect costs;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
23
Recensione:
Indirizzi per estratti:
Indirizzo: Shine, D Monmouth Med Ctr, Dept Med, 300 2nd Ave, Long Branch, NJ 07740 USA Monmouth Med Ctr 300 2nd Ave Long Branch NJ USA 07740 J 07740 USA
Citazione:
D. Shine et al., "Association of resident coverage with cost, length of stay, and profitability at a community hospital", J GEN INT M, 16(1), 2001, pp. 1-8

Abstract

OBJECTIVE: The effect of care by medical residents on hospital length of stay (LOS), indirect costs, and reimbursement was last examined across a range of illnesses in 1981; the issue has never been examined at a community hospital. We studied resource utilization and reimbursement at a community hospital in relation to the involvement of medical residents. DESIGN: This nonrandomized observational study compared patients discharged from a general medicine teaching unit with those discharged from nonteaching general medical/surgical units. SETTING: A 620-bed community teaching hospital with a general medicine teaching unit (resident care) and several general medicine nonteaching units (no resident care). PATIENTS: All medical discharges between July 1998 and February 1999, excluding those from designated subspecialty and critical care units. MEASUREMENTS AND MAIN RESULTS: Endpoints included mean LOS in excess of expected LOS, mean cost in excess of expected coat, mean payments, and mean profitability (payments minus total costs). Observed values were obtained from the hospital's database and expected values from a proprietary risk adjustment program. No significant difference in LOS between 917 teaching-unit patients and 697 nonteaching patients was demonstrated. Coats averaged $3,178 (95% confidence interval [CI] +/- $489) less than expected among teaching-unit patients and $4,153 (95% CI +/- $422) less than expected among nonteaching-unit patients. Payments were significantly higher per patient on theteaching unit than on the nonteaching units, and as a result, mean profitability was higher: $848 (95% CI +/- $307) per hospitalization for teaching-unit patients and $451 (95% CI +/- $327) for patients on the nonteaching units. Teaching-unit patients of attendings who rarely admitted to the teaching unit (nonteaching attendings) generated an average profit of $1,299 (95%CI +/- $613), while nonteaching patients of nonteaching attendings generated an average profit of $208 (95% CI +/- $437). CONCLUSIONS: Resident care at our community teaching hospital was associated with significantly higher costs but also with higher payments and greater profitability.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 08:26:19