Effects of caregiver specialty on cost and clinical outcomes following hospitalization for heart failure

Harjai, Kishore J., Boulos, Louis-Marie, Smart, Frank W, Turgut, Tansel, Krousel-Wood, Marie A., Stapleton, Dwight D., Mehra, Mandeep R., Murgo, Joseph P. and Ventura, Hector O. (1998) Effects of caregiver specialty on cost and clinical outcomes following hospitalization for heart failure. American Journal of Cardiology, 82 1: 82-85. doi:10.1016/S0002-9149(98)00234-3


Author Harjai, Kishore J.
Boulos, Louis-Marie
Smart, Frank W
Turgut, Tansel
Krousel-Wood, Marie A.
Stapleton, Dwight D.
Mehra, Mandeep R.
Murgo, Joseph P.
Ventura, Hector O.
Title Effects of caregiver specialty on cost and clinical outcomes following hospitalization for heart failure
Journal name American Journal of Cardiology   Check publisher's open access policy
ISSN 0002-9149
Publication date 1998-07
Sub-type Article (original research)
DOI 10.1016/S0002-9149(98)00234-3
Volume 82
Issue 1
Start page 82
End page 85
Total pages 4
Place of publication Bridgewater, NJ, United States
Publisher Excerpta Medica
Language eng
Formatted abstract
In 614 consecutive hospitalizations with the primary discharge diagnosis of diagnosis-related group (DRG) 127 (heart failure and shock), we sought to assess the effect of caregiver specialty (generalist, n = 217; cardiologist, n = 397) on hospital costs, length of stay, and in-hospital mortality. Patients treated by cardiologists were younger (68 vs 71 years) and less likely to have hypertension (52% vs 61%), but were more likely to be men (61% vs 44%), require an intensive care stay (13% vs 5%), have coronary artery disease (49% vs 23%), have a left ventricular ejection fraction <40% (74% vs 49%), and have lower systolic (132 vs 146 mm Hg)and diastolic (76 vs 81 mm Hg) blood pressures on admission. Predictors of acute disease severity were similarly distributed between the 2 groups. No difference was found between patients treated by cardiologists versus those treated by generalists with respect to crude or adjusted hospital cost, length of stay, and in-hospital mortality. However, in subsets of patients who required intensive care during hospitalization (n = 64), as well as those who did not (n = 550), care by cardiologists was associated with a lower adjusted hospital cost. Any potential cost savings that could have accrued from care by cardiologists was, however, negated by the higher proportion of patients treated by cardiologists who required intensive care during hospitalization. We conclude that when differences in clinical variables are adjusted, care by cardiologists versus generalists is associated with similar or lower hospital cost for patients with DRG 127. Our findings challenge the notion that in- patient care provided by specialists is more expensive than that provided by generalists.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Mon, 14 Mar 2011, 10:08:56 EST