The Cost and Efficiency of Hospital Care Provided by Primary Care Physicians and Medical Subspecialists
American Journal of Medical QualityPublished 1 September 1999
Edwin J. Zarling, Frank Piontek, Rajiv Kohli, James Carrier
Citations4
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TL;DR
Health care manpower projections should be re-evaluated in light of this information, and subspecialists and primary care physicians provide care that produces similar results for length of stay, charge, and mortality.
Abstract
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.
Keywords
Economics, Econometrics and FinanceHealth Professions
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