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- Nov 2018
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www.amjmed.com www.amjmed.com
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Davis and col-leagues (3) provide useful new data that enhance our un-derstanding of the effects of hospitalists on health sys-tems. In their study of a voluntary hospitalist system at alarge rural nonteaching hospital in Mississippi, theyfound that patients cared for by hospitalists had adjustedhospital stays that were 25% shorter, and costs that were12% less, than patients cared for by nonhospitalist inter-nists. For patients in the highest severity group, these sav-ings were even greater. Annualized, the authors extrapo-late that the hospitalists would have saved $2.5 millionhad they cared for all of the internists’ patients. As withprior studies that found similar reductions in resourceuse (4 –7), these substantial savings were achieved with-out diminishing quality or patient satisfaction. Nor wasthere evidence of cost shifting: hospitalists’ patients wereno less likely to be discharged to home (instead of anotherinstitution such as a skilled nursing facility) than werepatients of primary care internists. We can now state withconsiderable confidence that hospitalists markedly de-crease inpatient costs and lengths of stay with no compro-mise in quality or patient satisfaction.
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