Some time a few years back, there was a migration of primary care doctors and internists into the hospital setting to provide “hospitalist” care. I think many of these were fed up with private practice and insurance companies or just didn’t have the business savvy to stay afloat. Regardless, the idea was that these doctors would be much more efficient and allow for better hospital care and outcomes.
I had personal experience with a hospitalist when Keegan was born. A hospitalist would not release him the day he was born because of the genetic heel stick testing that is done on all newborns. Basically, the accuracy of the results is higher after 24 hours. So she wanted Keegan to stay for more than 24 hours so the testing could be done. Everyone else was free to go home should we choose to leave little newborn Keegan all alone…
The upsetting part is that there was NO reason this testing couldn’t have been done by his family doctor in a few days. But the hospitalist would hear nothing of it. Certainly expensive and frustrating.
Now, on to this particular study. The is strong data that hospitalist care truly does result in cost savings and short lengths of stay. The problem is that the cost savings are apparently only to the hospital.
The problem? While the Medicare costs were less in the hospital, the costs AFTER the hospital were greater with hospitalist use. Worse, less patients were discharged to home (vs a facility), were more likely to have future ER visits and more likely to be re-admitted into the hospital.
Some cost savings, huh? The hospital certainly wins out–they get more ER and more admissions when they use hospitalists!! I just wish I could run a business that ultimately left patients in a worse scenario than when they came in and I could make more money the second time around!
Of course, the true cost savings occur when the patient takes good care of their health and doesn’t need to go to the hospital in the first place. Without these changes and the continued use of hospitalists, the costs of the Medicare system will ultimately spiral beyond control.