Inpatient care in a community hospital: comparing length of stay and costs among teaching, hospitalist, and community services.

INTRODUCTION Specific patient care measures and cost of hospitalization are being studied as health care providers and payers are seeking methods to improve the hospital care of patients. This study's purpose was to examine the length of stay and cost of inpatient care by a family medicine teaching service in comparison with the hospitalists' and community physicians' services in the same community hospital. METHODS We analyzed inpatient admissions to either a family medicine teaching service (FMTS), hospitalist physician group, or the patient's own primary care community physician in a 290-bed, for-profit, community hospital over a 12-month period. Outcome variables investigated included length of stay, fixed costs, variable costs, and readmission rate. RESULTS A total of 5,453 hospital admissions were analyzed. Patients admitted to the FMTS experienced a significantly shorter length of stay and had significantly lower fixed, variable, and total costs per admission. No significant differences in readmission rates were noted. CONCLUSIONS The care provided by a teaching service as indicated by length of stay, costs, and readmission rates compared favorably with the care provided by other physicians.