Primary Care Physicians vs Hospitalists: Trends in Readmission, Discharge

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Thirty-day mortality was lower for patients cared for by PCPs than hospitalists.
Thirty-day mortality was lower for patients cared for by PCPs than hospitalists.

HealthDay News — Patients cared for in the hospital by their own primary care physician (PCP) have longer length of stay and are more likely to be discharged home than those cared for by hospitalists or other generalists, according to a study published online in JAMA Internal Medicine.

Jennifer P. Stevens, MD, from Beth Israel Deaconess Medical Center in Boston, and colleagues performed a retrospective study to examine differences in health care resource use and outcomes among hospitalized patients cared for by hospitalists, their own PCP, or other generalists. Data were obtained from Medicare Parts A and B claims data for 560,651 admissions.

The researchers found that patients cared for by PCPs and other generalists versus hospitalists had lengths of stay that were 12% and 6% longer, respectively. PCPs were more likely and other generalists were less likely to discharge patients home (adjusted odds ratios [AORs], 1.14 and 0.94, respectively). Patients cared for by PCPs had similar readmission rates at seven days and 30 days relative to patients cared for by hospitalists; readmission rates were greater for generalists at 7 and 30 days. Thirty-day mortality was lower for patients cared for by PCPs than hospitalists (AOR, 0.94), while the mortality rate was higher for those cared for by other generalists (AOR, 1.09).

"A PCP's prior experience with a patient may be associated with inpatient use of resources and patient outcomes," the authors write.

Reference

  1. Stevens JP, Nyweide DJ, Maresh S, Hatfield LA, Howell MD, Landon BE. Comparison of hospital resource use and outcomes among hospitalists, primary care physicians, and other generalists [published online November 13, 2017]. JAMA Intern Med. doi:10.1001/jamainternmed.2017.5824
  2. Willett LL, Landefeld CS. The costs and benefits of hospital care by primary physicians [published online November 13, 2017]. JAMA Intern Med. doi:10.1001/jamainternmed.2017.5833

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